Computational simulation of passive leg-raising effects on hemodynamics during cardiopulmonary resuscitation

DongAh Shin, Jiheum Park, Jung Chan Lee, Sang Do Shin, Hee Chan Kim

Research output: Contribution to journalArticle

Abstract

Background and objective The passive leg-raising (PLR) maneuver has been used for patients with circulatory failure to improve hemodynamic responsiveness by increasing cardiac output, which should also be beneficial and may exert synergetic effects during cardiopulmonary resuscitation (CPR). However, the impact of the PLR maneuver on CPR remains unclear due to difficulties in monitoring cardiac output in real-time during CPR and a lack of clinical evidence. Methods We developed a computational model that couples hemodynamic behavior during standard CPR and the PLR maneuver, and simulated the model by applying different angles of leg raising from 0° to 90° and compression rates from 80/min to 160/min. Results The simulation results showed that the PLR maneuver during CPR significantly improves cardiac output (CO), systemic perfusion pressure (SPP) and coronary perfusion pressure (CPP) by ∼40–65% particularly under the recommended range of compression rates between 100/min and 120/min with 45° of leg raise, compared to standard CPR. However, such effects start to wane with further leg lifts, indicating the existence of an optimal angle of leg raise for each person to achieve the best hemodynamic responses. Conclusions We developed a CPR-PLR model and demonstrated the effects of PLR on hemodynamics by investigating changes in CO, SPP, and CPP under different compression rates and angles of leg raising. Our computational model will facilitate study of PLR effects during CPR and the development of an advanced model combined with circulatory disorders, which will be a valuable asset for further studies.

Original languageEnglish
Pages (from-to)195-200
Number of pages6
JournalComputer Methods and Programs in Biomedicine
Volume140
DOIs
Publication statusPublished - 2017 Mar 1

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Resuscitation
Cardiopulmonary Resuscitation
Hemodynamics
Leg
Cardiac Output
Perfusion
Pressure
Monitoring

All Science Journal Classification (ASJC) codes

  • Software
  • Computer Science Applications
  • Health Informatics

Cite this

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title = "Computational simulation of passive leg-raising effects on hemodynamics during cardiopulmonary resuscitation",
abstract = "Background and objective The passive leg-raising (PLR) maneuver has been used for patients with circulatory failure to improve hemodynamic responsiveness by increasing cardiac output, which should also be beneficial and may exert synergetic effects during cardiopulmonary resuscitation (CPR). However, the impact of the PLR maneuver on CPR remains unclear due to difficulties in monitoring cardiac output in real-time during CPR and a lack of clinical evidence. Methods We developed a computational model that couples hemodynamic behavior during standard CPR and the PLR maneuver, and simulated the model by applying different angles of leg raising from 0° to 90° and compression rates from 80/min to 160/min. Results The simulation results showed that the PLR maneuver during CPR significantly improves cardiac output (CO), systemic perfusion pressure (SPP) and coronary perfusion pressure (CPP) by ∼40–65{\%} particularly under the recommended range of compression rates between 100/min and 120/min with 45° of leg raise, compared to standard CPR. However, such effects start to wane with further leg lifts, indicating the existence of an optimal angle of leg raise for each person to achieve the best hemodynamic responses. Conclusions We developed a CPR-PLR model and demonstrated the effects of PLR on hemodynamics by investigating changes in CO, SPP, and CPP under different compression rates and angles of leg raising. Our computational model will facilitate study of PLR effects during CPR and the development of an advanced model combined with circulatory disorders, which will be a valuable asset for further studies.",
author = "DongAh Shin and Jiheum Park and Lee, {Jung Chan} and Shin, {Sang Do} and Kim, {Hee Chan}",
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Computational simulation of passive leg-raising effects on hemodynamics during cardiopulmonary resuscitation. / Shin, DongAh; Park, Jiheum; Lee, Jung Chan; Shin, Sang Do; Kim, Hee Chan.

In: Computer Methods and Programs in Biomedicine, Vol. 140, 01.03.2017, p. 195-200.

Research output: Contribution to journalArticle

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AU - Kim, Hee Chan

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