Device for emergency treatment of cardiac arrest
20200390950 ยท 2020-12-17
Inventors
Cpc classification
A61B5/02042
HUMAN NECESSITIES
A61M5/3287
HUMAN NECESSITIES
A61B5/02055
HUMAN NECESSITIES
A61B5/065
HUMAN NECESSITIES
A61B2034/301
HUMAN NECESSITIES
International classification
A61B17/12
HUMAN NECESSITIES
Abstract
Disclosed is a device for providing resuscitation or suspended state through redistribution of cardiac output to increase supply to the brain and heart for a patient, the device comprising an electrically controllable redistribution component in the form of a catheter, which is attachable to the patient and being configured to interact with the patient to provide redistribution of the cardiac output to increase supply to the brain and heart, the redistribution component following a predefined reaction pattern based on an electrical signal, and computer means configured to: receive a patient data which identifies physiological and/or anatomical characteristics of the patient; and provide the electrical signal for the redistribution component based on the patient data or a standard response. The device also comprises means for detection of blood vessels and motorized means for introduction of the catheter into an artery.
The device may provide mechanisms to protect the aorta and the remaining anatomy of the patient from inadvertent damage caused by the disclosed device in any usage scenario of either correct intended usage or unintended usage.
Claims
1. An automated vascular catheter deployment device, which comprises means for detection of blood vessels and means for introduction of a catheter into a blood vessel, such as an artery or vein, wherein the means for introduction of the catheter comprises 1) means for motorized sideways movement of a percutaneous cannula or needle, 2) means for motorized introduction of the percutaneous cannula or needle into an artery or a vein via longitudinal axial movement of said cannula or needle, and 3) means for motorized introduction of the catheter into an artery or a vein through or across said cannula or needle; wherein the device is comprised in a housing or frame that is configured to be applied to a position of a human limb selected from a group consisting of: frontal part of the thigh, frontal part of the pelvis, frontal part of the groin, the wrist, frontal part of the arm and/or frontal part frontal part of the neck.
2. The device according to claim 1, wherein the means for detection of blood vessels comprises an ultrasound detection component or an infrared or near-infrared imaging component.
3. The device according to claim 1, wherein the cannula or needle can move sideways in a fixed or adjustable angle, preferably along a rail or cable.
Description
DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION
[0151] In the following, embodiments of the invention will be described in further details with reference to the drawing in which:
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[0167] Further scope of applicability of the present invention will become apparent from the following detailed description and specific examples. However, it should be understood that the detailed description and specific examples, while indicating preferred embodiments of the invention, are given by way of illustration only, since various changes and modifications within the scope of the invention will become apparent to those skilled in the art from this detailed description.
[0168] Redistributing the cardiac output during cardiac arrest may be carried out with the device illustrated in
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[0170] The device is capable of providing resuscitation or suspended state through redistribution of cardiac output to increase supply to the brain and heart for a patient. The illustrated device comprises an electrically or manually controllable redistribution component in the form of an occlusion catheter sub-part 2 suitable for insertion through a femoral arterial line
[0171] The occlusion catheter facilitates redistribution of the cardiac output by reducing blood flow across a balloon which is inflated in the aorta and thereby increases supply to the brain and heart.
[0172] The device is adapted for automatic operation. The CPU is configured to receive a patient data which identifies physiological and/or anatomical characteristics of the patient and to provide the electrical signal for controlling the redistribution component and/or for presenting the physiological and/or anatomical characteristics for a user based on the patient data or a standard response. In the illustrated embodiment, the occlusion catheter comprises two sensors, one being above the balloon and one being inside the balloon, or alternatively below the balloon. The sensor may particularly be pressure sensors which can provide blood pressure which herein is considered as patient data. These patient data may be generated e.g. during external cardiac compression carried out on the patient.
[0173] The signals from the sensors are transmitted to the CPU which, based on the computer program code, controls checks the location of the catheter in the aorta and the patent safety during use of the device and which controls the filing of the balloon. The CPU thereby follows a predefined reaction pattern based on the electrical signal from the sensor.
[0174] The device has a screen 3 which forms part of a user interface. The user further comprises control buttons and visual feedback through LED lights and/or text display. As illustrated in
[0175] The digitally sensing catheter sub component may be designed as illustrated in
[0176] The catheter body comprises an elongate tube 4 with a lumen 5 wherein saline can flow in both directions, i.e. both to and from the balloon and wherein the sensor units 6, 7 and sensor wires 8 can pass through the extent of the catheter body, as illustrated in
[0177] The balloon (not shown) can be made from low durometer urethane, with a wall thickness of 0.05 mm, an overall length of 30 mm, and a diameter from 20-40 mm depending on filling degree, having a burst pressure of at least 500 mmHg.
[0178] The balloon may be configured in size to occlude the aorta of the patient.
[0179] The sensors may pressure sensors of the type MEMS, e.g. MEMS pressure sensor, MEM2000, Metallux SA, Switzerland.
[0180] The sensors can be interfaced with a print circuit board via USB. The USB connection allows for the signal to be processed digitally and used as input for the software algorithms as illustrated in
[0181] The device further comprises a controller component. The controller component may contain a membrane keyboard with LEDs for user interface, integrated circuit, a pump, hereunder e.g. a piston pump or roller pump, battery, and any other additional component for controlling, powering, or operating the device in accordance with the invention.
[0182] In the embodiments of the device of the invention where a roller pump (i.e. a peristaltic pump) is included, it is of particular importance to avoid deformation and/or loss of function (due to e.g. shape memory of the polymer of the tubes) during storage of the flexible tubes with which the rollers are in contact during operation of the device. It is envisaged that the device may be stored for prolonged periods of time (e.g. in a rescue vehicle) before it comes into use, and in the event the flexible tubes were constantly compressed by the rollers in the roller pump during storage, the operation of the device could be seriously compromised due to changes in shape of the tubes. One solution to this problem provided by the present invention is to ensure that the tubes are not compressed by the rollers during storage by including a mechanism that prevents the rollers from being in contact with the tubes during storage but which can render the rollers operational and bring them in contact with the tube(s) at the time of operation. One simple solution is to secure the roller heads in fixed positions during manufacture by e.g. a spring load mechanism, which can be easily removed (e.g. by removal of a pin from a socket) and thereby allow the roller head(s) to attain functional position(s): Typically, rollers in a roller pump are pushed towards the tube wall by a spring mechanism, and when packaging the device, the springs of this mechanism can be compressed so that the rollers are kept in a locked position.
[0183] Another issue related to the potential prolonged storage times is the fact that tubing, in particular catheters, may attain an undesired shape (again due to shape memory of soft plastic polymers) due to the physical shape of the storage package. Solutions to this have been devised in the prior artfor instance, U.S. Pat. No. 7,670,331 describes systems for ensuring correct shape of catheters upon insertion after prolonged storage. In the present invention, catheter tubes are typically stored by folding the catheter tube in a J or U shape to ensure that only the parts of the tubing where shape memory is an insignificant problem will be folded during storage.
[0184] Another embodiment of the invention is illustrated in
[0185] The catheter subpart may be inserted into the aorta of the patient by locating and puncturing the femoral artery and by inserting the device through the defined opening. The device could be used for the puncturing and placement procedures and these procedures may be integrated into the device. The device can aid the user from unintended harmful events occurring to the patient through the active security mechanism modes illustrated in
[0186] The controller component of the device can be attached or fixed to the leg 10 of a patient through e.g. a wraparound leg belt or an adhesive fixation pad.
[0187] In another embodiment of the invention, the device can be implanted into a patient. This device may function through wireless coordination and electricity transfer between the device and a pacemaker, ICD or similar implantable cardiovascular diagnostic or therapeutic medical device, as illustrated in
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[0189] In another embodiment of the invention which is detailed elsewhere herein, the device functions as part of a robotic puncture and insertion system, further decreasing the room for user error. In other words, the device is integrated with automated means for vessel recognition
[0190] Expectedly, the system includes a variation of the above configurations and modes.
[0191] In certain embodiments, the device of the invention is stored prior to use as a sealed outer compartment comprising a protection cover for the outside of the display and parts of the device that come into direct contact with the patient and an inner compartment which comprises the majority of the functional components (e.g. battery, CPU, pump, circuitry, memory, tubing, actuator etc.). These two compartments can be stored separately from the parts introduced into the patient, or the parts introduced into the patient may be part of the outer compartment. This arrangement of components allows that the outer compartment and its components can be readily removed for later destruction/disinfection after use and that the inner compartment and its components can be partially recycled or refurbished. One convenient arrangement is in the form of an oyster package, where the two compartments are disengaged immediately after use.
[0192] Typically, connectors between the insertable parts (cannulas, catheter tubes) are those state of the art connector systems that ensure sterile connection in order to avoid contamination of both patient and personnel operating the device.
[0193] A preferred embodiment of the invention entails that the redistribution component is in the form of a catheter, which is introduced into the femoral artery and advanced to the correct position in the aorta. To ensure sterility the catheter is conveniently covered by a sheath that can be handled by the end user. The catheter is allowed to more freely relative to the inner surface of this sheath, meaning that the catheter can be advanced stepwise through the entrance cannula by simply grapping the catheter via the external sheath which is then gradually peeled off towards the proximal end of the catheter until the catheter is completely introduced. To further assist in maintaining sterility, the tip of catheter is embedded in a hollow grip (a handling means) that allows the user to introduce the tip into the entry cannula without directly touching any part of the catheter.
[0194] A specific embodiment of a catheter with sheath and handling means is shown in
EXAMPLE 1
Operation of a Device of the Invention
[0195] The device is started by pressing the button ON or it is started by unpacking the device e.g. by releasing an attachment to the electrical circuit between device and battery. The user uncovers the catheter and inserts the catheter into the patient. Once the user has completed the procedure, the user presses INFLATE, and the system enters the Position verification mode.
Position Verification Mode
[0196] When the criteria for the correct position is met, the indicator Position correct starts blinking green and the indicator Pumping 573 starts blinking yellow, then the system enters Actuator (inflation) mode.
[0197] If the correct position is not achieved or if the correct position is lost, then indicator Pumping stops blinking, an alarms sounds and Retry placement X starts blinking, until INFLATE is pressed again.
Actuator (Inflation) Mode
[0198] The actuator is activated and the balloon is inflated. When the criteria for a filled balloon is reached the actuator is stopped, the indicator Pumping stops blinking yellow and Self-adjustment mode is entered.
[0199] If the criteria are not met after one minute, or the user presses the DEFLATE button, the Deflation mode is entered followed by Retry placement X starting to blink and staying lit until INFLATE is pressed again.
Self-Adjustment Mode
[0200] The indicator Balloon filled.diamond-solid. starts blinking green. The self-adjustment mode regulates the pressure in the balloon to a correct pressure according to the criteria.
[0201] If the criteria can't be held, an alarm sounds, the deflation mode is entered followed by Retry placement X starting to blink until INFLATE is pressed again, or if the user presses the DEFLATE button, the Deflation mode is entered.
Deflation Mode
[0202] The indicator Pumping starts blinking yellow. The actuator is activated and the balloon is deflated.
[0203] When the balloon is deflated Balloon deflated.diamond-solid. starts blinking blue until the user presses INFLATE again.
Glossary
[0204] P1 is Pressure sensor 1, as illustrated in
Positioning Criteria
[0205] The maximum pressure measured by P1 is above 15 mmHg and has a delta between the max and min pressure measured higher than 5 mmHg. 50 Hz.
Filling Criteria
[0206] P2 reach the pressure measured by P11.20. 50 Hz
Self-Adjustment Criteria
[0207] P2 is still within the following range: (P11.10)-(P11.30). 0.1 Hz.
[0208] The device may signal the user with the following visual and/or auditory signals: [0209] Message A: Filling. Continue CPR. [0210] Message B: Retry placement. Balloon is now empty. [0211] Message C: Aorta Occlusion success. [0212] Message D: Deflation done.
EXAMPLE 2
Simulation Experiment
[0213] A model of the human ascending aorta, aortic arch, and common femoral arteries was produced in silicone rubber. The model was submerged in water and internal pressure (100 mmHg) in the model was applied via a connected water column. Chest compressions were simulated by manually applying pressure to an attached balloon.
[0214] The test device was inserted from an opening in the part of the model corresponding to the left common femoral artery so as allow the tip to reach a position corresponding to just proximal of the renal arteries. The occlusion balloon was inflated while recording MEMS pressure sensor data from the tip of the catheter and from the interior of the balloon compartment.
[0215] It was demonstrated that the positioning and occlusion of the redistribution catheter can be controlled and verified through the use of software-hardware integration mechanisms. For example, measuring the correct pressures during filling corresponding to the catheter tip being in the aorta (and e.g. not misplaced in the renal artery) allows pressure control of the filling of the balloon as a function of the pressures intended to be countered. In other words, if the catheter is not placed in the correct position, filling of the balloon counter the aortic pressure and has the consequence that the pressure measured at the tip drops to zero instead of remaining at the level of the aortic pressure.
EXAMPLE 3
In Vivo Experiment
[0216] A prototype device was tested in two pilot animal trials. The animals were healthy Danish farm pigs of 30-38 kg, which were sedated using pentobarbital (Mebumal) 50 mg/ml, 6 mg/kg/h and ketamine (Ketaminol vet) 100 mg/ml, 15 mg/kg/h. The animals further were administered 2000 unites of unfractionated heparin.
[0217] The animals were mechanically ventilated and oxygen levels were set to 23% oxygen prior to cardiac arrest. During the experiment the animals were continuously supplied with saline (0.9% NaCl) at an infusion speed of 2 l/h.
[0218] Cardiac arrest was induced by applying 9 V DC directly to the heart by electrodes introduced via the right jugular vein. Cardiac arrest was defined as a systolic blood pressure <25 mmHg for more than 5 seconds.
[0219] ROSC was defined as a pulsatile rhythm with a systolic aortic blood pressure >60 mm Hg maintained for at least 5 min.
[0220] Arterial blood pressure, venous blood pressure and heart rate were measured with intravascular gauges in the aortic arch through the right carotid artery at the junction with the aorta, and the right jugular vein entering the central vena cava.
[0221] Pig no. 1 had the following baseline values prior to induction of cardiac arrest: heart rate 85 bpm, arterial blood pressure 98/63 mmHg, venous blood pressure 15 mmHg. After the induction of cardiac arrest, the pig was left in no-flow state for 1 min. Hereafter mechanical chest compressions were delivered with the LUCAS 2 device (Physiocontrol) continued for an additional 5 min. After the pig had sustained a cardiac arrest for a total of 6 min, the prototype device was introduced to the aorta through the right femoral artery. The parameters after the 6 min. of cardiac arrest were measured as the following: Heart rate 0 bmp, with a mechanical setting at 100 compressions/min, blood pressure was 34/23 mmHg, and central venous pressure was 20 mmHg. Hereafter the prototype device was turned on and the effect were left to take hold for 1 min. The values were measured to the following regarding 1 min of sustained use of the prototype device: Heart rate 0, with a mechanical setting at 100/compressions/min, central arterial blood pressure was 59/28 mmHg, central venous pressure was 22 mmHg.
[0222] The use of the prototype device demonstrated an increase of the central arterial pressure, and thus also of the coronary perfusion pressure and cerebral perfusion pressure, from systolic 34 mmHg to 59 mmHg, and a sustained venous pressure going from 20 to 22 mmHg. The coronary perfusion pressure, the central parameter in cardiac resuscitation, is calculated as the difference between the systolic central arterial pressure and the central venous pressure. We are thus able to demonstrate an increase of the coronary perfusion pressure with 164%.
[0223] Pig no. 2 was subjected to the same conditions as Pig no. 1, but cardiac arrest was effected by inducing blood loss (700 ml) by bleeding from the right femoral artery prior to instigation of the treatment.
[0224] Pig no. 2 had the following baseline values prior to induction of cardiac arrest: heart rate 105 bpm, arterial blood pressure 96/42 mmHg, venous blood pressure 12 mmHg. After blood loss the values were: heart rate: 93 bpm, arterial blood pressure: 35/20 mmHg, central venous pressure: 10 mmHg. Treatment was commenced. After 1 minute of treatment the values had changed to: heart rate: 95 bpm, arterial blood pressure: 55/30 mmHg, central venous blood pressure: 10 rrimHg.
[0225] Hence, by using the prototype of the invention, it was achieved to obtain a 57% increase the arterial blood pressure, whereas an 80% increase in coronary perfusion pressure was obtained.
Numbered Embodiments
[0226] The invention relates in particular to the following consecutively numbered embodiments: [0227] E1. A device for providing resuscitation or suspended state through redistribution of cardiac output to increase supply to the brain and heart for a patient, the device comprising [0228] an electrically or manually controllable redistribution component attachable to the patient and being configured to interact with the patient to provide redistribution of the cardiac output to increase supply to the brain and heart, the redistribution component following a predefined reaction pattern based on an electrical signal, and [0229] computer means configured to: [0230] receive a patient data which identifies physiological and/or anatomical characteristics of the patient; and [0231] provide the electrical signal for controlling the redistribution component and/or for presenting the physiological and/or anatomical characteristics for a user based on the patient data or a standard response. [0232] E2. The device according to embodiment E1, where the computer means comprises memory means having stored therein a predefined definition of the electrical signal as a response to the patient data. [0233] E3. The device according to embodiment E1 or E2, comprising patient data generation means configured to generate patient data during external cardiac compression carried out on the patient, the patient data generation means configured to generate the patient data by sensing biosignals from the patient. [0234] E4. The device according to embodiment E3, where the patient data generation means is configured to sense biosignals from a blood vessel or a tissue compartment. [0235] E5. The device according to any one of embodiments E1-E4, wherein the redistribution component comprises or consists of an aortic retrograde perfusion pump. [0236] E6. The device according to any one of embodiments E1-E4, where the redistribution component comprises an elongated body extending between a proximal end and a distal end, the distal end being insertable into the patient, where the redistribution component comprises an aortic expansion member and inflation means connected to the aortic expansion member for expanding the aortic expansion member. [0237] E7. The device according to embodiment E6, wherein the inflation means is adapted to be capable of being operated manually by a user. [0238] E8. The device according to embodiment E6 or E7, wherein the inflation means is adapted to be capable of being operated automatically. [0239] E9. The device according to any one of embodiments E6-E8, further comprising an adaptable tissue protection mechanism configured to: [0240] determine a blood pressure or blood flow present in a blood vessel of the patient during cardiac compression; [0241] determine an aortic expansion member characteristics defining a degree of expansion of the aortic expansion member based on the determined blood pressure or blood flow; and [0242] to provide an electrical signal for controlling the inflation means in accordance with the determined aortic expansion member characteristics. [0243] E10. The device according to embodiment E9, where the adaptable tissue protection mechanism is configured to determine the aortic expansion member characteristics based on the determined blood pressure or blood flow multiplied by a predetermined factor. [0244] E11. The device according to any one of embodiments E6-E10, where the electrical signal specifies a degree of expansion of the aortic expansion member, a timing of expansion of the aortic expansion member, an upper limit of expansion, a duration of expansion of the aortic expansion member, and/or a timing of contraction of the aortic expansion member. [0245] E12. The device according to any one of embodiments E6-E11, where the inflation means comprises a piston or roller pump. [0246] E13. The device according to any one of embodiment E6-E12, further comprising a location safety mechanism comprising at least one first sensor capable of determining a biosignal which is characteristic for aorta of the patient and an electronic circuit configured to verify a position of the expansion member in aorta based on the biosignal. [0247] E14. The device according to embodiment E13, where the at least one first sensor comprises a pressure sensor. [0248] E15. The device according to embodiment E13 or E14, where the first sensor is located on the redistribution component to determine the biosignal in a position distal to the aortic expansion member. [0249] E16. The device according to embodiment E15, where the device is configured to use data from the first sensor in combination with data from sensors located at other locations. [0250] E17. The device according to embodiment E16, where at least one of the other sensors is located on the redistribution component to determine the biosignal in a position proximal to the aortic expansion member. [0251] E18. The device according to any one of embodiments E13-E17, where the location safety mechanism is configured to determine whether the aortic expansion member is located in a position selected from a group consisting of: a pulsating vessel in accordance with being the aorta of the patient, a pulsating vessel not in accordance with being the aorta, a pulsating vessel being indeterminate as the aorta of the patient, a venous vessel, a tissue compartment not being a blood vessel and a tissue compartment indeterminate in location. [0252] E19. The device according to any one of embodiments E13-E18, further comprising a second sensor inside the aortic expansion member or proximal to the expansion member. [0253] E20. The device according to any one of embodiments E13-E19, wherein the device is configured with a feedback loop receiving data from at least one of the first and second sensor, to control the filling of the aortic expansion member. [0254] E21. The device according to any one of the embodiments E6-E20, further comprising a first failsafe mechanism, configured to determine a pressure in the aortic expansion member and to determine a volume of the aortic expansion member, to determine a ratio between the pressure and the volume, and to compare the ratio with an upper and lower threshold value, and to execute a control sequence including stopping of further inflation of the aortic expansion member or deflation of the aortic expansion member. [0255] E22. The device according to any one of embodiments E6-E21, further comprising a user interface for use of selectable operation of the inflation means, wherein said user interface optionally can accommodate the shape of the underlying surface of a patient or a physical surface in the vicinity of a patient and/or can accommodate to external pressure exerted on the outer surface of a patient. [0256] E23. The device according to any one of embodiments E6-E22, comprising a halt interface allowing manually selectable deflation of the aortic inflation member. [0257] E24. The device according to embodiment E23, where the halt interface is configured to execute the selectable deflation over a predefined number of seconds. [0258] E25. The device according to any one of embodiments E6-E24, comprising a patient state monitor configured to determine a biosignal representing Return of Spontaneous Circulation (ROSC), and to control deflation of the aortic expansion member based on the determined signal. [0259] E26. The device according to any one of embodiments E6-E25, further comprising an electronic human interface with a graphical or audio user interface configured to provide instructions or information related to the location and degree of filling of the aortic expansion member in the aorta of the patient, said human interface optionally being attachable in a fixed position on a patient, wherein said human interface optionally can accommodate the shape of the underlying surface of a patient or a physical surface in the vicinity of a patient and/or can accommodate to external pressure exerted on the outer surface of a patient. [0260] E27. The device according to any one of embodiments E6-E26, further comprising at least one sensor for determining pressure, flow, O.sub.2 saturation or concentration, and/or volume data significant for pressure, flow and/or volume of a fluid inside the aortic expansion member or inside a blood vessel or tissue of the patient. [0261] E28. The device according to embodiment E27, where the computer means is configured to compare the pressure, flow and/or volume data with reference input data and based on the comparison to verify a position of the aortic expansion member in the body. [0262] E29. The device according to embodiment E27 or E28, where the computer means is configured to determine the size and type of blood vessel by analyzing the pressure flow and/or volume data continuously. [0263] E30. The device according to any one of embodiments E27-E29, where the computer means is configured to activate a failsafe for some verified positions in the body or limits based on sensor data analysis, thereby stopping the redistribution component interaction with the patient, the expansion of the aortic member or initiation of contraction of the aortic member. [0264] E31. The device according to any one of embodiments E27-E30, wherein an interactive human user guide is configured to provide information related to a position of the aortic expansion member in the patient, the information being determined based on the pressure, flow and/or volume data. [0265] E32. The device according to any one of embodiments E1-E31, further comprising means for ultrasound imaging data in the guidance of the user. [0266] E33. The device according to embodiment E32, wherein at least part of the redistribution component exhibits enhanced ultrasound detection capability. [0267] E34. The device according to any one of embodiments E1-E33, which further comprises at least one transponder and transceiver system for location verification of the redistribution component and/or of the aortic expansion member. [0268] E35. The device according to any one of embodiments E1-E34, which further comprises at least one transponder and transceiver system for determination of the position of the outer boundary of the aortic expansion member. [0269] E36. The device according to embodiment E34 or E35, wherein at least one transponder is positioned in the part of the device intended to be introduced into a patient. [0270] E37. The device according to any one of embodiments E34-E36, wherein at least one transceiver is positioned in the part of the device intended to be introduced into a patient. [0271] E38. The device according to any one of embodiments E34-E37, where at least one transponder or at least one transceiver is adapted to be positioned on the external surface of a patient in a non-invasive manner. [0272] E39. The device according to any one of embodiments E1-E38, where the patient data includes parameters selected from the group consisting of: aortic blood pressure, aortic blood flow, duration of cardiac arrest, expiratory CO.sub.2, ECG, blood pressure, compression rate and depth, pulse, respiratory frequency, cardiac output redistribution degree, aortic O.sub.2 saturation or concentration, cerebral or peripheral saturation, temperature, fluid administered, pharmaceuticals administered, biochemical data, and ultrasound imaging. [0273] E40. The device according to any one of embodiments E1-E39, where the aortic expansion member comprises an aortic occluding balloon. [0274] E41. The device according to embodiment E40, further compromising means for filling the aortic occluding balloon with a liquid or a gas. [0275] E42. The device according to embodiment E41, further comprising a handheld unit comprising the computer means and the filling means and being attachable to the aortic occluding balloon. [0276] E43. The device according to embodiment E41, further comprising an human interface unit comprising the filling means and being attachable to the aortic occluding balloon, said human interface optionally being attachable in a fixed position on a patient and wherein said human interface is optionally integrated with the human interface defined in embodiment E26 and/or the handheld unit defined in embodiment E42, wherein said interface unit optionally can accommodate the shape of the underlying surface of a patient or a physical surface in the vicinity of a patient and/or can accommodate to external pressure exerted on the outer surface of a patient. [0277] E44. The device according to embodiment E42 or 43, wherein the aortic occluding balloon is pre-attached to the handheld unit. [0278] E45. The device according to any one of embodiments E1-E44, where the computer means is configured to receive input data from the redistribution component. [0279] E46. The device according to any one of embodiments E1-E45, further comprising a component attachable to the patient and being configured to administer fluids and drugs to the patient, wherein said component optionally can accommodate the shape of the underlying surface of a patient or a physical surface in the vicinity of a patient and/or can accommodate to external pressure exerted on the outer surface of a patient. [0280] E47. The device according to embodiment E46, further compromising the means to administer timed and controlled amount of fluids and/or drugs. [0281] E48. The device according to any one of embodiments E1-E47, further comprising an additional component from the group consisting of: a patient monitor, a vital signs monitor, a watch, an external chest compression device, a respirator, an ECG monitor, a defibrillator, a pacemaker, a pH measurement device, an ultrasound device, an ECMO/ECLS device, a body cooling device, an infusion pump, a capnograph, a ventricular assist device, a dialysis device, touchscreen and/or telecommunications device. [0282] E49. The device according to any one of embodiments E1-E48, the redistribution component comprising of a component with the means for tilting the patient in a head down or head up tilt. [0283] E50. The device according to any one of embodiments E1-E49, further comprising means for a self-test system, double circuitry, and usage event data recording. [0284] E51. The device according to any one of embodiments E1-E50, which includes means for detection of blood vessels and means for introduction of the redistribution component into an artery. [0285] E52. The device according to embodiment E51, wherein the means for detection of blood vessels comprises an ultrasound detection component, an infrared or near-infrared imaging component. [0286] E53. The device according to embodiment E51 or E52, wherein the means for introduction of the redistribution component comprises 1) means for motorized movement of a percutaneous cannula or needle, 2) means for motorized introduction of the percutaneous cannula or needle into an artery, and 3) means for motorized introduction of the redistribution component into an artery through or across said cannula or needle. [0287] E54. The device according to any one of embodiments E1-E53, wherein the computer means communicates with at least one other therapeutic and/or monitoring device so as to allow coordination of the operation of said therapeutic devices and the device according to any one of the preceding embodiments. [0288] E55. The device according to embodiment E54, wherein the at least one other therapeutic and/or monitoring device is selected from a cardiac resynchronization therapy device, a cardioverter-defibrillator, and a cardiac pacemaker. [0289] E56. A device according to any one of embodiments E1-E6, which is adapted to be delivered to an implanted in a human body. [0290] E57. The device according to embodiment E56, which is configured to effect redistribution of cardiac output in response to lowered systolic or diastolic blood pressure over a period of time of a duration that implies a health risk in a patient. [0291] E58. The device according to embodiment E56 or E57, which is adapted to implantation in the ascending aorta. [0292] E59. The device according to any one of embodiments E56-E58, which includes aortic anchoring means, such as struts or an expandable frame. [0293] E60. The device according to any one of embodiments E56-E59, which comprises a power source, preferably rechargeable. [0294] E61. The device according to any one of embodiments E56-E60, wherein the redistribution component comprises an aortic expansion member as defined in any one of the preceding embodiment or comprises an aortic occlusion component such as a mechanical iris or a shutter mechanism. [0295] E62. An automated vascular catheter deployment device, which comprises means for detection of blood vessels and means for introduction of a catheter into an artery. [0296] E63. The device according to embodiment E62, wherein the means for detection of blood vessels comprises an ultrasound detection component, an infrared or near-infrared imaging component. [0297] E64. The device according to embodiment E62 or E63, wherein the means for introduction of the redistribution component comprises 1) means for motorized sideways movement of a percutaneous cannula or needle, 2) means for motorized introduction of the percutaneous cannula or needle into an artery via longitudinal axial movement of said cannula or needle, and 3) means for motorized introduction of the catheter into an artery through or across said cannula or needle. [0298] E65. The device according to any one of embodiments E62-E64, wherein the cannula or needle can move sideways in a fixed or adjustable angle, preferably along a rail or cable. [0299] E66. The device according to any one of embodiments E62-E65, which is comprised in a housing or frame that can conform to the shape of the upper part of a patient frontal part of the thigh. [0300] E67. A method for providing resuscitation or suspended state in a human cardiac arrest patient, said method comprising subjecting the patient to heart massage (chest compression) while at the same time ensuring redistribution of the cardiac output to preferentially supply blood to the brain and the heart. [0301] E68. The method according to embodiment E67, wherein said redistribution is accomplished by at least one of the following: [0302] occlusion of the aorta caudal to the left subclavian artery; [0303] head-down or head-up tilting of the patient so as to reach an angle of between 30 and 90 degrees relative to the horizontal plane; [0304] applying an external compression force onto the abdomen and/or thigh(s) and/or arm(s) so as to reduce the perfusion distal to the external compression force; [0305] passively raising the legs to reach an angle between 30 and 90 degrees relative to the horizontal plane. [0306] E69. The method according to embodiment E67 or E68, wherein said chest compression is manual or accomplished by use of a mechanical chest compression device. [0307] E70. The method according to any one of embodiments E67-E69, wherein at least one of the following treatments is/are also provided to the patient: [0308] administration of fluids, including saline and buffers such as bicarbonate, [0309] administration of vasopressive drugs, including vasopressin and analogues, [0310] administration of a tissue-protecting agent, such as erythropoietin; [0311] administration of anti-arrhythmic drug, such as amiodarone; [0312] reduction of body temperature, such as by use of cold IV-fluid infusion, cooling catheters, transnasal evaporative cooling, extracorporeal cooling or total liquid ventilation with temperature controlled perfluorocarbons. [0313] E71. The method according to embodiment E70, wherein the treatments are provided repeatedly, optionally according to a fixed sequence. [0314] E72. The method according to any one of embodiments E67-E71, which comprises that redistribution is accomplished by occlusion of the aorta caudal to the left subclavian artery. [0315] E73. The method according to embodiment E72, wherein occlusion is accomplished by introducing a device according to any one of embodiments E1-E46 into the aorta, preferably via the femoral artery, and subsequently decreasing or interrupting the blood flow distal to the redistribution component by expanding the redistribution component of said device. [0316] E74. The method according to embodiment E73, wherein the redistribution component is expanded in a controlled manner in response to measurement(s) that indicate the degree of occlusion and correct placement of said device in the patient's aorta. [0317] E75. The method according to embodiment E74, wherein said measurement(s) is/are selected from the group consisting of: [0318] duration of expansion redistribution component usage; [0319] blood flow passing by the redistribution component; [0320] blood pressure distal of the redistribution component, optionally combined with blood pressure proximal to the redistribution component; [0321] aortic O.sub.2 saturation distal of, and preferably in close proximity to, the redistribution component, optionally combined with arterial O.sub.2 saturation proximal of the redistribution component. [0322] E76. The method according to any one of embodiments E73-E75, wherein expansion of the redistribution component is controlled manually or by the computer means of said device to avoid incorrect positioning or expansion degree of said device and by activating the failsafe of embodiment E9 in case said device is verified to be incorrectly positioned thereby interrupting the expansion of the redistribution component to allow subsequent correct positioning. [0323] E77. The method according to any one of embodiments E67-E76, wherein the redistribution is temporarily interrupted at regular or irregular intervals so as to ensure sufficient perfusion of all parts of the body of the patient. [0324] E78. The method according to any one of embodiments E67-E77, which acts during or as a bridge to one or more of therapeutic hypothermia; angioplasty, including PCI and angiography; dialysis; administration of drugs such as vasopressors, thrombolytic drugs such as fibrinolytics, fluids, bicarbonate, antidotes, and antiarrhythmic drugs; the use of ultrasound, X-ray, CT, or MR; intubation; mechanical ventilation; ventricular assist devices; heart transplantation, including artificial heart transplantation; surgery, including CABG surgery and valve surgery; blood transfusion; placement of external or internal pacemaker or ICD; catheter ablation; thromboendarterectomy; defibrillation; transportation; ECMO; ECLS and cardiopulmonary bypass. [0325] E79. The method according to any one of embodiments E67-E78, further comprising lowering the restriction on perfusion delivered to the brain and heart through the use of a vasodilator, hereunder specifically sodium nitroprusside or nitroglycerin and repeated administration of sodium nitroprusside or nitroglycerin, hereunder repetition in intervals of 2-10 minutes. [0326] E80. The method according to embodiment E79, further comprising the use of an aortic expansion member to prevent the systemic vascular collapse caused by the vasodilator. [0327] E81. The method according to any one of embodiments E47-E60, further comprising the use of any one of the following: active compression-decompression CPR, impedance threshold device, adenosine administration, controlled pauses in the CPR (e.g. compressions for 20 seconds, then a pause in compressions for 20 seconds.) [0328] E82. A method for providing resuscitation or suspended state through redistribution of cardiac output to increase supply to the brain and heart for a human in cardiac arrest or imminent cardiac arrest, the method comprising subjecting the patient to external chest compression while at the same time ensuring redistribution of the cardiac output accomplished by occlusion of the aorta caudal to the left subclavian artery, and comprising lowering the restriction on perfusion delivered to the brain and heart through the use of a vasodilator, hereunder specifically sodium nitroprusside or nitroglycerin, hereunder repetition in intervals of 2-10 minutes. [0329] E83. A method according to embodiment E82, further acting as a bridge to one or more of the following: ECMO; ECLS; cardiopulmonary bypass; angioplasty, including PCI and angiography; dialysis; therapeutic hypothermia, hereunder cold IV-fluid infusion, cooling catheters, transnasal evaporative cooling, extracorporeal cooling or total liquid ventilation; administration of drugs, hereunder vasopressors or vasodilators, hereunder sodium nitroprusside or nitroglycerin, thrombolytic drugs such as fibrinolytics, fluids, bicarbonate, antidotes, tissue-protecting agents and antiarrhythmic drugs, such as amiodarone; the use of ultrasound, X-ray, CT, or MR; intubation; mechanical ventilation; ventricular assist devices; surgery, including CABG surgery and valve surgery; blood transfusion; placement of external or internal pacemaker or ICD; catheter ablation; thromboendarterectomy; heart transplantation; defibrillation; transportation. [0330] E84. A method for providing resuscitation or suspended state through redistribution of cardiac output to increase supply to the brain and heart for a human in cardiac arrest or imminent cardiac arrest, the method comprising subjecting the patient to external chest compression while at the same time ensuring redistribution of the cardiac output accomplished by sustained abdominal compression or abdominal binding, and comprising lowering the restriction on perfusion delivered to the brain and heart through the use of a vasodilator, hereunder specifically sodium nitroprusside or nitroglycerin, hereunder repetition in intervals of 2-10 minutes, and comprising acting as a bridge to one or more of the following: ECMO; ECLS; cardiopulmonary bypass; angioplasty, including PCI and angiography; dialysis; therapeutic hypothermia, hereunder cold IV-fluid infusion, cooling catheters, transnasal evaporative cooling, extracorporeal cooling or total liquid ventilation; administration of drugs, hereunder vasopressors or vasodilators, hereunder sodium nitroprusside or nitroglycerin, thrombolytic drugs such as fibrinolytics, fluids, bicarbonate, antidotes, tissue-protecting agents and antiarrhythmic drugs, such as amiodarone; the use of ultrasound, X-ray, CT, or MR; intubation; mechanical ventilation; ventricular assist devices; surgery, including CABG surgery and valve surgery; blood transfusion; placement of external or internal pacemaker or ICD; catheter ablation; thromboendarterectomy; heart transplantation; defibrillation; transportation. [0331] E85. A method for stopping or reducing bleeding from tissue(s) or organ(s), hereunder during e.g. surgery or other situations where bleeding occur of said tissue(s) or organ(s), the method comprising inserting an occlusion device into a blood vessel, which supplies said tissue(s) or organ(s) with blood, wherein said occlusion device is reversibly expanded to occlude said blood vessel and wherein the pressure exerted by the expanded occlusion device on the wall of the blood vessel is adapted to be between 1 and 2 times the vascular pressure difference across the occlusion device. [0332] E86. The method according to embodiment E85, wherein the pressure exerted by the expanded occlusion device on the wall of the blood vessel is adapted to be at most 1.9 times the vascular pressure difference across the occlusion device, such as at most 1.8, at most 1.7, at most 1.6, at most 1.5, at most 1.4, at most 1.3, at most 1.2 and at most 1.1 times. [0333] E87. The method according to embodiment E85 or E86, wherein the occlusion device includes or is attached to at least one vascular pressure sensor, which can determine the vascular pressure in said blood vessel. [0334] E88. The method according to embodiment E87, wherein the at least one pressure sensor is positioned in said vessel between the occlusion in said vessel and said tissue(s) or organ(s) and/or is positioned in the part of said vessel which is separated from said tissue(s) or organ(s) by the occlusion. [0335] E89. The method according to any one of embodiments E85-E88, wherein the occlusion device is part of a device as embodimented in any one of embodiments E1-E66, where said occlusion device is identical to the aortic expansion member of embodiment E6 or may be a modified version of said aortic expansion member, which is adapted be able to fit into other blood vessels.