ABSTRACT
There is increasing evidence that children and adolescents can efficiently transmit SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1-3). During July-August 2020, four state health departments and CDC investigated a COVID-19 outbreak that occurred during a 3-week family gathering of five households in which an adolescent aged 13 years was the index and suspected primary patient; 11 subsequent cases occurred.
Subject(s)
Coronavirus Infections/epidemiology , Disease Outbreaks , Family , Pneumonia, Viral/epidemiology , Adolescent , Adult , Aged , COVID-19 , Child , Female , Humans , Male , Middle Aged , Pandemics , United States/epidemiology , Young AdultABSTRACT
AIM: The objectives were: 1) replicate key elements of Head Up (HUP) cardiopulmonary resuscitation (CPR) physiology in a traditional swine model of ventricular fibrillation (VF), 2) compare HUP CPR physiology in pig cadavers (PC) to the VF model 3) develop a new human cadaver (HC) CPR model, and 4) assess HUP CPR in HC. METHODS: Nine female pigs were intubated, and anesthetized. Venous, arterial, and intracranial access were obtained. After 6â¯min of VF, CPR was performed for 2â¯min epochs as follows: Standard (S)-CPR supine (SUP), Active compression decompression (ACD) CPRâ¯+â¯impedance threshold device (ITD-16) CPR SUP, then ACDâ¯+â¯ITD HUP CPR. The same sequence was performed in PC 3â¯h later. In 9 HC, similar vascular and intracranial access were obtained and CPR performed for 1â¯min epochs using the same sequence as above. RESULTS: The mean cerebral perfusion pressure (CerPP, mmHg) was 14.5⯱â¯6 for ACDâ¯+â¯ITD SUP and 28.7⯱â¯10 for ACDâ¯+â¯ITD HUP (pâ¯=â¯.007) in VF, -3.6⯱â¯5 for ACDâ¯+â¯ITD SUP and 7.8⯱â¯9 for ACDâ¯+â¯ITD HUP (pâ¯=â¯.007) in PC, and 1.3⯱â¯4 for ACDâ¯+â¯ITD SUP and 11.3⯱â¯5 for ACDâ¯+â¯ITD HUP (pâ¯=â¯.007) in HC. Mean systolic and diastolic intracranial pressures (ICP) (mmHg) were significantly lower in the ACDâ¯+â¯ITD HUP group versus the ACDâ¯+â¯ITD SUP group in all three CPR models. CONCLUSION: HUP CPR decreased ICP while increasing CerPP in pigs in VF as well as in PC and HC CPR models. This first-time demonstration of HUP CPR physiology in humans provides important implications for future resuscitation research and treatment.