Cardiorespiratory dynamics of rescuers during cardiopulmonary resuscitation in a hypoxic environment.

OBJECTIVE: We had previously experienced a case involving prolonged cardiopulmonary resuscitation (CPR) on Mt. Fuji (3776 m), demanding strenuous work by the rescuers. The objective of this study was to compare the effect of compression-only and conventional CPR on oxygen saturation of rescuers in a hypoxemic environment. METHODS: Changes in percutaneous arterial oxygen saturation (SpO2) and heart rate during CPR action were measured in a hypobaric chamber with barometric pressure adjusted to be equivalent to 3700 m above sea level (630-640 hPa). Thirty-three volunteers performed CPR with or without breaths using a CPR mannequin. RESULTS: In a 3700-m-equivalent environment, SpO2 was reduced only when CPR was performed without breaths (P < .05, one-way analysis of variance (ANOVA) post hoc Tukey test). Heart rate increased during CPR regardless of the presence or absence of breaths. Mean scores on the Borg scale, a subjective measure of fatigue, after CPR action in the 3700-m-equivalent environment were significantly higher (15 ±â€¯2) than scores after CPR performed at sea level (11 ±â€¯2, P < .01, paired t-test). No lethal dysrhythmia was found in subjects with a wearable electrode shirt. CONCLUSIONS: Prolonged CPR at high altitude exerts a significant physical effect upon the condition of rescuers. Compression-only CPR at high altitude may deteriorate rescuer oxygenation, whereas CPR with breaths might ameliorate such deterioration.

Neurosurgical robotic system for brain tumor removal.

PURPOSE: Brain tumor (e.g., glioma) resection surgery, representing the first step for many treatments, is often difficult and time-consuming for neurosurgeons. Thus, intelligent neurosurgical instruments have been developed to improve tumor removal. METHODS: The concept and robotic structure of intelligent neurosurgical instruments were introduced. These instruments consist of a surgical robot, a master device and operating software. The robot incorporates a surgical motion base and tool manipulator, including a volume control suction tool. Open Core Control software was developed for connecting intelligent neurosurgical instruments through a network connection and integrating the instruments into a system. RESULTS: Mechanical evaluation tests on the components and a preliminary system evaluation were performed. A phantom model was fixed on a head frame, and a tumor-removal procedure was successfully performed using prototype intelligent neurosurgical instruments. CONCLUSION: Intelligent neurosurgical instruments are feasible and suitable for on-going evaluation in practical tasks, including in-vivo animal testing.