title: LUCAS 2™ device, compression depth, and the 2010 cardiopulmonary resuscitation guidelines.
abstract: The 2010 guidelines for cardiopulmonary resuscitation recommends that the chest be compressed at least 5 cm, with evidence that depths exceeding 5 cm may further aid resuscitation. The current piston-based mechanical device LUCAS 2™ is programmed to deliver a compression depth of 5 cm. We report 2 cases in which the LUCAS 2™ device failed to generate physiological surrogates of blood flow (ie, end-tidal carbon dioxide tension and aortic diastolic blood pressure) at levels indicative of effective chest compressions. A switch to manual compressions allowing greater compression depth yielded higher end-tidal carbon dioxide tension and arterial blood pressure. These cases depict limitations of the LUCAS 2™ device and the importance of guiding chest compression by physiological parameters. Consideration should be given to modifications to the LUCAS 2™, allowing rescuers to increase depth when required to optimize the hemodynamic efficacy of chest compression.
authors.affiliation: Rosalind Franklin University of Medicine and Science and Captain James A. Lovell Federal Health Care Center, North Chicago, IL 60064, USA. kovidtrivedi@gmail.com
authors.forename: Kovid
authors.initials: K
authors.lastname: Trivedi
authors.forename: Vesna
authors.initials: V
authors.lastname: Borovnik-Lesjak
authors.forename: Raúl J
authors.initials: RJ
authors.lastname: Gazmuri
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D017809:Fatal Outcome; D006323:Heart Arrest / Q000628:therapy*; D006336:Heart Massage / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D055815:Young Adult