title: Cardiopulmonary resuscitation in microgravity: efficacy in the swine during parabolic flight.
abstract: BACKGROUND
  The International Space Station will need to be as capable as possible in providing Advanced Cardiac Life Support (ACLS) and cardiopulmonary resuscitation (CPR). Previous studies with manikins in parabolic microgravity (0 G) have shown that delivering CPR in microgravity is difficult. End tidal carbon dioxide (PetCO2) has been previously shown to be an effective non-invasive tool for estimating cardiac output during cardiopulmonary resuscitation. Animal models have shown that this diagnostic adjunct can be used as a predictor of survival when PetCO2 values are maintained above 25% of pre-arrest values.
  
  
  METHODS
  Eleven anesthetized Yorkshire swine were flown in microgravity during parabolic flight. Physiologic parameters, including PetCO2, were monitored. Standard ACLS protocols were used to resuscitate these models after chemical induction of cardiac arrest. Chest compressions were administered using conventional body positioning with waist restraint and unconventional vertical-inverted body positioning.
  
  
  RESULTS
  PetCO2 values were maintained above 25% of both 1-G and O-G pre-arrest values in the microgravity environment (33% +/- 3 and 41 +/- 3). No significant difference between 1-G CPR and O-G CPR was found in these animal models. Effective CPR was delivered in both body positions although conventional body positioning was found to be quickly fatiguing as compared with the vertical-inverted.
  
  
  CONCLUSIONS
  Cardiopulmonary resuscitation can be effectively administered in microgravity (0 G). Validation of this model has demonstrated that PetCO2 levels were maintained above a level previously reported to be predictive of survival. The unconventional vertical-inverted position provided effective CPR and was less fatiguing as compared with the conventional body position with waist restraints.
authors.affiliation: NASA-Johnson Space Center, Medical Operations Branch, Mail Code SD26, 2101 NASA Rd., Houston, TX 77058-3696, USA.
authors.forename: Smith L
authors.initials: SL
authors.lastname: Johnston
authors.forename: Mark R
authors.initials: MR
authors.lastname: Campbell
authors.forename: Roger D
authors.initials: RD
authors.lastname: Billica
authors.forename: Stevan M
authors.initials: SM
authors.lastname: Gilmore
mesh_terms: D000818:Animals; D016887:Cardiopulmonary Resuscitation; D005118:Extraterrestrial Environment; D010101:Oxygen Consumption; D013552:Swine; D014893:Weightlessness