Show Ogden Monday February 2 1 SS7 9A Health Squeeze vests new CPR hope Calif (AP) — d inflatable that squeeze cardiac patients’ chests might save more lives with less injury than heart massage say Tcscarchers who have tried the new method on animals and humans The vest looks like a cross between a boater's life jacket and a blood pressure cuff Air pumped through a hose by an automatic system makes the vest inflate and deflate compressing the chest repeatedly to restore blood flow to the heart and brain The vest has been in development since 1981 by doctors at Johns Hopkins Medical School in rescuers often place a tube in the patient's airway to prevent air from escaping during compression and to supply air between com- Baltimore sures MONTEREY vests pressions The CPR vest applies uniform pressure around the chest cavity not just the front of the rib cage so air is less prone to escape from the lungs allowing better blood flow and reducing the risk of injury Halperin said After early studies on pigs Johns Hopkins researchers used the vest to apply maximum pressure on eight dogs shocked into cardiac arrest Blood flow was restored but three dogs suffered severe lung or liver injury Such injury didn’t occur at lower pres- It requires five more years of redesign and testing before it might be available for widespread use by paramedics taking cardiac arrest patients to hospitals Johns Hopkins cardiologist Dr Henry said recently during the 14th American Heart Association’s annual Science Writers Forum Cardiac arrest kills more than 300000 Americans annually and usually is caused by ventricular brillation chaotic electrical activity in the heart muscle that halts blood flow When blood flow stops for more than a short time the heart often can’t be restarted with the preferred technique defibrillation in which the chest is shocked electrically Cardiopulmonary resuscitation is then necessary before defibrillation can work Manual CPR in which a rescuer repeatedly compresses the patient’s chest has been controversial with critics contending it often doesn’t work causes broken ribs and organ injury and may not improve chances of survival after cardiac arrest During manual CPR chest compression pushes air out of the lungs reducing the beneficial effect o pressure on blood flow So Next three groups of seven dogs each were shocked into cardiac arrest Vests were used on one group manual CPR with standard pressure on the second and manual CPR with high pressure on the third All seven dogs resuscitated with the vests survived without injury Standard manual CPR injured two of the seven dogs in that group and only one survived cardiac armanual CPR rest restored blood flow about as well as the vests but only three survived and four suffered broken ribs or liver injury Halperin said the study showed CPR vests can restore blood flow as well as manual CPR but with less injury Vests have been tried with approval from the Johns Hopkins institutional review board on a few humans who couldn’t donate their organs because of age or disease and who were about to be disconnected from respirators and allowed to die Halperin said the results in reversing cardiac arrest “were not quite as good as we’ve gotten in dogs” so the vests must be redesigned for people Study: Patients not getting heart drugs (about new uses for medications) from drug company promotions” Lipicky said by telephone from his Gaithersburg Md home “If that’s the state of affairs in medicine that’s a sad state of affairs” The lack of FDA approval for either drug does not prohibit use he added “A physician can use any drug on the market for whatever they think is in the patient’s best interest” The study headed by Cohn was completed in late 1985 announced last March and published two months later by the New England Journal of Medicine It was the first to show drug therapy can prolong the lives of people with congestive heart failure a potentially fatal condition in which the heart can’t pump as much blood as the body requires often leaving patients short of breath Dr William Last March Parmley president of the American College of Cardiology called Cohn’s research “a landmark study" Congestive heart failure patients treated with ISDN and hydralazine for one year had a 38 percent lower death rate than those getting a placebo a 25 percent lower rate after two years and a 23 percent lower rate after three Cohn reported in last year’s study Lipicky agreed pharmaceutical companies have little reason to spend money promoting the drugs but said agency criteria require at least two studies that benefits unshow less there is a demonstration the medications reduce heart failure symptoms and allow patients to exert themselves more ISDN tends to lose its effecuse for tiveness during casting doubt on its conangina very profitable tribution to prolonging lives he An FDA decision on any pendadded “If you don’t know these ing application should occur ) soon but Cohn’s study doesn’t drugs are useful in treatment of congestive heart failprovide evidence to meet the ei ure why should they prolong for criteria approving agency's thcr drug for heart failure said hfer Cohn said the drugs slow proLipicky Trade secrets laws that gression of heart failure and preapply to all applications preventshowed ed him from confirming the vious small studies short-terbenefits He didn’t ISDN application is pending were submitstudies if the know is is lie what saying “Basically that physicians mainly learn ted to the FDA MONTEREY Calif (AP) — Few congestive heart failure victims are getting medications that could make them live longer says a researcher who conducted a landmark study of the drugs and accuses the government of inaction y However Dr Raymond the US Food and Drug Administration director of heart and kidney drugs said the medicines can be prescribed but the agency hasn’t approved them for congestive heart failure Lipicky said approval will occur only if the FDA is convinced the drugs are effective for the disease which afflicts 4 million to 5 million Americans The FDA approved both drugs for other uses years ago: hydralazine for high blood pressure and isosorbide dinitrate or ISDN for heart pain called angina Both re- lax blood vessels allowing blood to flow more freely and taking strain off the failing heart “The drugs Used together have the potential for extending the life expectancy of millions of people in this country with heart failure" but without FDA approval doctors don’t receive drug company brochures that would spur widespread use for that purpose said Dr Jay N Cohn director of the drug study and head of the University of Minnesota Medical School’s cardiovascular division Wyeth Laboratories application for FDA approval of ISDN is pending but no one applied for approval of hydralazine Cohn said recently during the American Heart Association’s 14th annual Science Writers Forum He said drug companies lack incentives to promote the medicines because they are 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