By Ben Bartenstein

Pioneer Press

ST. PAUL, Minn. — After 25 years of clinical trials, St. Paul is among the first cities to install new CPR devices -- inspired by a toilet plunger -- that increase by half a patient's one-year survival rate from cardiac arrest.

The installation in 50 St. Paul fire trucks and ambulances this month precedes a national rollout later in the summer. St. Paul and Minneapolis were among seven trial sites, allowing first responders to test the apparatus for three years.

Dr. Keith Lurie, a physician at the University of Minnesota, invented the mechanism, which has gone through six clinical trials since 1991, before the U.S. Food and Drug Administration approved its use in March.

"People wake up on these devices," said Dr. R.J. Frascone, the EMS medical director at Regions Hospital. "You get almost normal vital signs. It's amazing."

According to Frascone, a nationwide deployment of the devices would save more than 10,000 patients each year.

Use of the devices has increased by 50 percent a patient's one-year survival rate from cardiac arrest, according to the FDA.

Sudden cardiac arrest is the No. 1 cause of death nationwide, with 11 percent of victims outside hospitals surviving, according to the Centers for Disease Control and Prevention, but Minnesota has spearheaded national efforts to reduce fatal outcomes. The state boasts the highest cardiac arrest survival rate in the country, which the Minnesota Department of Health reported was double the national average.

"The Twin Cities is the epicenter of this," said Frascone, who has collaborated with Lurie for more than 20 years. "We're on the cutting edge."

After a decade at Yale, Stanford Medical School and the University of Pennsylvania, Lurie dedicated more than a quarter-century to testing devices to improve cardiac arrest survival. This included a $4.5 million grant from the National Institutes of Health and collaborations with researchers in France, Germany and Japan.

But his most profound discovery stemmed from a toilet plunger.

While working at the University of California, San Francisco, in 1988, Lurie met a man who claimed his children resuscitated him with their household plunger. Lurie and his cardiologist colleagues laughed at the notion, but when the man returned months later, a survivor of two more cardiac arrests thanks to the same toilet device, Lurie quit laughing and went to his lab.

"Some of the greatest discoveries in medicine were serendipitous," Frascone said, "and this was one of them."

Unlike conventional CPR devices that spring the chest downward, a plunger's suction also springs the chest back up, increasing blood flow to the heart and brain for the next compression phase. Lurie's apparatus, the ResQCPR, is actually two devices: an active compression/decompression and an impedance threshold device, or ACD/ITD CPR.

The ITD "turbocharges CPR," ventilating a patient during the initial phase and blocking airflow to the lungs while the chest is recoiling, said Lurie. The apparatus includes a stress gauge and timer, instructing operators on the application of force.

"It's not rocket science," Frascone said. "It's easier to train than standard CPR."

Zoll Medical Corp. in Chelmsford, Mass., acquired Lurie's Roseville-based Advanced Circulatory Systems Inc. in December and is producing several thousand units in Wisconsin. ACDs run $695 retail with single-use ITDs costing $100 each. The devices require a prescription available to emergency providers and clinicians, said Elizabeth Groover, vice president of marketing at Zoll.

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©2015 the Pioneer Press (St. Paul, Minn.)