# Phase II, Head Up Cardiopulmonary Resuscitation Device

> **NIH NIH R44** · ADVANCEDCPR SOLUTIONS LLC · 2022 · $928,395

## Abstract

Abstract
Sudden cardiac arrest (SCA) is a leading cause of death in the USA, with only 3-20% neurologically intact
survival for >350,000 out-of-hospital SCA patients each year. Even after patients are initially resuscitated, many
die within a week from severe brain injury. The goal of this application is to improve neurologically-intact survival
rates after pre-hospital and in-hospital SCA. The Phase I pre-clinical studies showed 1) elevation of the head
and thorax during active compression decompression (ACD) CPR with an impedance threshold device (ITD)
doubled brain blood flow versus ACD+ITD CPR in the flat position and, 2) controlled and sequential head and
thorax elevation with ACD+ITD CPR resulted in a 6-fold increase in neurologically-intact survival versus
conventional CPR in the flat position. This novel method of CPR is called Head Up Position (HUP) CPR. It works
by harnessing gravity to enhance venous blood flow from the brain to the heart, lower intracranial pressure, and
enhance cardiac output. The first human HUP CPR device, the EleGARDTM, was designed, built, and tested with
Phase I funding support. The EleGARD subsequently received FDA 510k clearance and has been used to help
treat >400 SCA patients to date. Based upon these positive outcomes, the Phase II objectives are to 1) Design,
develop, and build an improved EleGARD-2 to accelerate time to device application and increase adoption rates
through a) a reduction in size and weight and an improved user interface, b) addition of regional cerebral oximetry
(rSO2) and, c) incorporation of automated positive pressure breath delivery to increase crew safety in the age of
Covid-19; 2) Demonstrate neurologically-intact survival is superior with ACD+ITD HUP CPR versus ACD+ITD
CPR flat in a pig model that includes salvage with extra-corporeal membrane oxygenation (ECMO) to evaluate
the potential benefit of HUP CPR with the rapidly evolving use of ECMO for SCA; and 3) Demonstrate HUP CPR
utilizing EleGARD-2 reduces brain injury in a pig model of SCA utilizing advanced imaging techniques. The next
generation HUP CPR device will be easier to store, carry, and deploy, will provide rSO2 to better guide care,
and provide automated breath delivery to increase crew safety and reduce the number of rescuers needed to
perform CPR. The animal studies will help determine the potential for HUP CPR to extend physiologic viability
during resuscitation in refractory ventricular fibrillation until better hemodynamic support in the form of ECMO is
available, and help determine if HUP CPR reduces brain injury, as determined by MRI and measurement of
biochemical markers. Collectively, Phase II funding will support the development of the next generation HUP
CPR platform and accelerate adoption of this innovative technology to improve neurologically-intact survival
rates after SCA.

## Key facts

- **NIH application ID:** 10485256
- **Project number:** 5R44HL139184-03
- **Recipient organization:** ADVANCEDCPR SOLUTIONS LLC
- **Principal Investigator:** Keith Lurie
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $928,395
- **Award type:** 5
- **Project period:** 2017-07-17 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10485256

## Citation

> US National Institutes of Health, RePORTER application 10485256, Phase II, Head Up Cardiopulmonary Resuscitation Device (5R44HL139184-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10485256. Licensed CC0.

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