Research in microgravity finds mechanical piston device most effective for CPR during spaceflight

Research in microgravity finds mechanical piston device most effective for CPR during spaceflight

(IN BRIEF) A study presented at ESC Congress 2025 has found that a standard piston-based chest compression device is the only method able to achieve effective CPR depth in microgravity conditions, outperforming NASA’s current “handstand method” and other tested devices. Conducted aboard parabolic flights by CNES, the research showed the device reached a median compression depth of 53 mm compared with 34.5 mm for manual CPR. Although cardiac arrest is rare in astronauts, researchers say future missions and space tourism may increase the risk, raising the question of whether automatic compression devices should be included in spaceflight medical kits despite weight and space limitations. The findings may also have implications for CPR in remote Earth environments.

(PRESS RELEASE) MADRID, 27-Aug-2025 — /EuropaWire/ — New research presented at the European Society of Cardiology (ESC) Congress 2025 has shown that a standard mechanical piston device delivers more effective chest compressions during simulated microgravity compared with manual methods currently recommended for astronauts. The findings could influence future CPR guidelines for spaceflight, where cardiac arrest remains a rare but potentially mission-ending medical emergency.

Cardiac arrest in space presents unique challenges because both rescuer and patient float in microgravity, making chest compressions difficult. The current NASA protocol for the International Space Station recommends the “handstand method,” where the rescuer braces their legs against the spacecraft while pushing on the patient’s chest. However, experiments conducted aboard the A310 Air Zero G aircraft at the French space agency CNES revealed that this method failed to meet the compression depth standards required by international resuscitation guidelines.

Researchers tested three types of automatic chest compression devices alongside manual methods during parabolic flight maneuvers that created repeated 22-second phases of weightlessness. A standard piston-driven device achieved a median compression depth of 53 mm, within the recommended 50–60 mm range, while the handstand method only reached 34.5 mm. Other devices, including a compression band system and a smaller piston device, were also found to be less effective, achieving median depths of 29 mm.

“This is the first time we have identified a method that delivers compressions deep enough to be effective under microgravity conditions,” said lead investigator Nathan Reynette from Université de Lorraine – CHRU de Nancy. “While space agencies will need to weigh the practical issues of carrying such devices aboard spacecraft, our results strongly suggest that mechanical chest compression tools could save lives in space.”

Automatic compression devices are already used on Earth in limited scenarios, such as during helicopter transport or prolonged resuscitation. While not superior to manual CPR in typical settings, they offer advantages in environments where compressions are physically challenging. The study authors believe their findings could extend beyond space medicine, offering potential applications for extreme and resource-limited environments such as submarines or Arctic bases.

Although the immediate risk of cardiac arrest during spaceflight remains low due to stringent astronaut medical screening, longer missions and the advent of space tourism may increase the likelihood of medical emergencies. Researchers say the next step will be to assess whether space agencies should include piston compression devices in future mission medical kits despite their size and weight.

The study was conducted by a collaboration between clinicians from CHU de Nancy, researchers from Université de Lorraine and Université de Paris, engineers from the Laboratoire Georges Charpak at École Nationale des Arts et Métiers ParisTech, CNES, and Novespace.

The abstract “Cardiac arrest in space: how to perform cardiopulmonary resuscitation during spaceflight?” will be presented on 31 August at ESC Congress 2025 in Madrid

References and notes:

*Microgravity is the condition in which people or objects appear to be weightless in space. It is popularly known as zero gravity, however technically in space very small gravitational forces still exist, so the term microgravity is more accurate.

German Society of Aerospace Medicine (DGLRM) and the European Society of Aerospace Medicine Space Medicine Group (ESAM-SMG) guidance on CPR in space: https://pubmed.ncbi.nlm.nih.gov/33138865/

https://pubmed.ncbi.nlm.nih.gov/33773835/

The abstract « Cardiac arrest in space : how to perform cardiopulmonary resuscitation during spaceflight? » will be presented at the session Management of out-of-hospital cardiac arrest which takes place on 31 August from 10:15 to 11:00 am CEST at Station 5 – Research Gateway

About ESC Congress 2025

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