Validating lower extremity counterpulsation during CPR by computer simulated evolution

Nowadays the outcome of Cardiopulmonary Resusciation (CPR) is dismal. There has been some research showing that if lower extremity counterpulsation is applied during CPR, it might augment coronary perfusion pressure, which is the most important hemodynamic merit of CPR. But lower extremity counterpulsation has not been widely recognized and used during CPR yet. In this paper, a computer model was constructed to simulate hemodynamics of CPR. Based on this computer model and under two simple restrictions, computer simulated evolution was performed to get evolved waveforms for external pressures applied during CPR from randomly chosen waveforms. The results show that the pattern of lower extremity counterpulsation is embodied in the evolved waveforms, thus validating the use of lower extremity counterpulsation during CPR. Our simulation studies show that lower extremity counterpulsation might improve hemodynamics of CPR and deserves further research.