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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Therese Djärv, Karolinska Institute, Stockholm, Sweden
- Second opponent: Professor Jon-Kenneth Heltne, University of Bergen
- Third member and chair of the evaluation committee: Professor II Theis Tønnessen, University of Oslo
Chair of the Defence
Professor II Per Steinar Halvorsen, University of Oslo
Principal Supervisor
Chief Consultant Lars Wik, Oslo University Hospital
Summary
Haemodynamic and other means of physiologic monitoring, represents the backbone of the research needed to better understand how we can improve cardiopulmonary resuscitation (CPR). It can also be used during CPR to identify how different treatment adjustments affect the patient. In our main study on 210 cardiac arrest patients, we sought to use haemodynamic monitoring to investigate the effects of a new mechanical chest compression device. It provides active compression-decompression CPR (mACD-CPR) by adding additional lift in the decompression phase. We hypothesized that the measurements of capnometry, invasive blood pressures and cerebral oximetry would improve compared to standard mechanical CPR. While we found a slight increase in the cerebral oximetry recordings with mACD-CPR, we also found that neither blood pressure nor capnometric measurements behaved as expected.
After a thorough review of our data and the available literature on each parameter we concluded that too often, the monitor does not find nor display those data fond to be of importance in laboratory based haemodynamic studies.
The two other studies in this PhD project addressed the lack of available methods to measure ventilation parameters during CPR. We hypothesized that changes in impedance of the transthoracic current between the defibrillator pads could reveal more information about the timing and the volume of ventilations. We found that the form and the amplitude of ventilation induced waves in the transthoracic impedance curve may be used to develop a non-invasive ventilation monitoring tool.
This thesis provides an overview of modern cardiac arrest physiology concepts before each study is presented and interpreted. Then, the strengths and weaknesses for each of the haemodynamic parameters are discussed. Several suggestions to how haemodynamic monitoring can be improved are presented.
Additional information
Contact the research support staff.