Minn. company developing plunger-like device for CPR compressions


By Christopher Snowbeck
The St. Paul Pioneer Press

ROSEVILLE, Minn. — People performing CPR chest compressions might fare better using a device that functions a bit like a toilet plunger rather than using their hands.

That's the unlikely notion at the heart of Roseville-based Advanced Circulatory Systems.

The company is developing a product called CardioPump that paramedics and hospital workers could use to compress and decompress the chest during CPR.

Not actually shaped like a toilet plunger, the CardioPump is a one-pound device consisting of a suction cup that rescuers attach to the chest of a sudden cardiac arrest victim and a handle that is grasped with two hands. A gauge on the handle shows how much force rescuers should use.

The effect of using the device, the company believes, is similar to what happened in three unusual instances where caregivers actually used a toilet plunger to save a man's life in California back in the 1980s.

"Doing good CPR with a pair of hands is tough to do," said Mike Black, the chief executive officer of Advanced Circulatory Systems, when explaining why such a device might be needed.

If CardioPump sounds familiar, it's because the device has been the subject of two high-profile studies in the Twin Cities over the past 15 years. Even so, it still isn't approved for use in the U.S.

That's part of the reason Advanced Circulatory Systems has much more in its sights than just plunging the chest. The company is busy selling and developing other products that caregivers can use when treating patients in emergency settings.

One is a mask product called ResQGARD that helps patients with low blood pressure. Another product is called ResQPOD, a fist-shaped device that strategically impedes airflow through medical facemasks.

The device both prevents unnecessary air from entering the chest during CPR and guides caregivers on exactly when they should ventilate. Restricting airflow to the chest during CPR is important because it increases blood flow to the heart and brain.

Allina Medical Transport -- the ambulance division of Minneapolis-based Allina Health System -- has been using the ResQPOD since 2006.

"We've got some data that is positive, and shows these devices work," said Dr. Charles Lick, an emergency department physician who is medical director of Allina Medical Transportation. "I'm working with a group within Allina to promote use of those devices within the hospital, too."

ResQPOD is the top source of revenue at Advanced Circulatory Systems. The company hopes to use proceeds from an upcoming fundraising effort of $3 million to $5 million to accelerate sales and marketing.

The long-term goal for Advanced Circulatory Systems is to market an entire platform of products that increase blood pressure and/or decrease intracranial pressures, Black said. It's a business model that reflects what caregivers in the field need.

"You need a cocktail of devices and therapies," Black said.

In time, Advanced Circulatory Systems hopes that CardioPump -- the plunger-inspired device that's still under development -- will be part of that cocktail.

Dr. Keith Lurie of the University of Minnesota invented the CardioPump after treating a patient in California who'd been saved three times by family members who used a toilet plunger on his chest.

"It was a family from Iran that didn't have insurance, and so (the patient) couldn't have the angioplasty procedure he needed until we saw him," Lurie said. "He would go into cardiac arrest, and his family would plunge his chest."

It likely worked, Black speculated, because the plunger focused caregivers on pulling up on the chest following compression. That sort of "active decompression" is thought to help patients through a sort of bellows effect in which negative pressure pulls more blood back to the heart, so it can be pumped back out with the next compression.

CardioPump's design is intended to create negative pressure in the chest cavity. It works best in tandem with the ResQPOD, the company says, because that device ensures that air -- rather than blood -- isn't pulled in to fill the void.

A first large study of the device in the 1990s hit snags and wasn't completed. Eventually, the original product's manufacturer -- Ambu International of Denmark -- sold it to Advanced Circulatory Systems, which Lurie founded in 1997 under the name CPRx.

About five years ago, a committee at the Food and Drug Administration helped establish new guidelines for the evidence needed to win approval for a product like CardioPump. Advanced Circulatory Systems went on to initiate a 2,500-patient CardioPump study.

So far, the study has been funded by the National Institutes of Health. About 1,600 patients have enrolled, Black said.

If all goes well, researchers could finish enrolling patients during 2011, which would set the stage for U.S. regulatory approval in 2012.

"New enrollment has been on hold while we seek additional funding from the NIH to complete the study," Black said.

Copyright 2009 St. Paul Pioneer Press
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