Martin Pallares Perez1, David H Tang2 and Noam Gavriely3,4*
1Facultad de Medicina, Centro de Estudios Universitarios Xochicalco Campus Ensenada, San Francisco 1139, Fraccionamiento Misión, CP 22830, Ensenada, B.C., México
2Jerry L Pettis Memorial Va Medical Center, Loma Linda, CA USA
3Department of Physiology and Biophysics, Technion, Israel Institute of Technology, Haifa, Israel (retired)
4OHK Medical Devices Ltd. Tirat Carmel, Israel
Submission: October 25, 2024; Published: November 06, 2024
*Corresponding author: Noam Gavriely, Department of Physiology and Biophysics, Technion, Israel Institute of Technology, Haifa, Israel
J Cardiol
Abstract 
Out-of-hospital cardiac arrest (CA) with CPR has poor outcomes. We report our experience with 17 patients admitted to the Eisenhower Emergency Department (ED) in Rancho Mirage, CA, who underwent treatment with a novel autotransfusion tourniquet (A-TT, Oneg HaKarmel, Israel).
Methods: The Eisenhower IRB authorized this report. All patients were in terminal arrest after receiving CPR throughout the 22-56 minutes of transport to the ED. One or both legs received the A-TT upon arrival at the ED. This study is derived from a retrospective analysis of emergency department medical records.
Results: Seven patients were removed because (a) the collapse was unwitnessed (two patients), (b) non-cardiac etiology (four patients), or (c) improper use of A-TT (one patient). The collapse of the remaining 10 patients was witnessed and attributed to cardiac causes. Seven of these 10 individuals had ROSC within 1-5 minutes following the A-TT application. Five ROSC patients were transferred to the ICU, and one was released neurologically intact.
Discussion: As a “mechanical vasoconstrictor,” the A-TT sends blood from the legs to the core and prevents the blood from returning. This directs CPR cardiac output to the vital organs. The rate of return of spontaneous circulation (ROSC) in this small cohort is higher than expected, considering the significant time elapsed since the onset of cardiac arrest.
Conclusion: Mechanical distal-to-proximal shifting of the legs’ blood by the A-TT has the potential to improve the rate of ROSC when applied together with standard CPR. Earlier use of A-TT may lead to a better outcome.
Keywords: Hypoglycemia; Gastrointestinal hemorrhage; Hyperthermia; Myocardial infarction; Chronic atrial fibrillation; Cardiomyopathy
Abbreviations: CA: Cardiac Arrest; A-TT: Auto-Transfusion Tourniquet; CPP: Coronary Perfusion Pressure; CBF: Cerebral Blood Flow; ROSC: Return of Spontaneous Circulation; AICD: Automatic Implantable Cardiac Defibrillation
