{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T20:32:36Z","timestamp":1784925156913,"version":"3.55.0"},"reference-count":41,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>(1) Background: Cardiopulmonary resuscitation (CPR), as a form of basic life support, is critical for maintaining cardiac and cerebral perfusion during cardiac arrest, a medical condition with high expected mortality. Current guidelines emphasize the importance of rapid recognition and prompt initiation of high-quality CPR, including appropriate cardiac compression depth and rate. As space agencies plan missions to the Moon or even to explore Mars, the duration of missions will increase and with it the chance of life-threatening conditions requiring CPR. The objective of this review was to examine the effectiveness and feasibility of chest compressions as part of CPR following current terrestrial guidelines under hypogravity conditions such as those encountered on planetary or lunar surfaces; (2) Methods: A systematic literature search was conducted by two independent reviewers (PubMed, Cochrane Register of Controlled Trials, ResearchGate, National Aeronautics and Space Administration (NASA)). Only controlled trials conducting CPR following guidelines from 2010 and after with advised compression depths of 50 mm and above were included; (3) Results: Four different publications were identified. All studies examined CPR feasibility in 0.38 G simulating the gravitational force on Mars. Two studies also simulated hypogravity on the Moon with a force of 0.17 G\/0,16 G. All CPR protocols consisted of chest compressions only without ventilation. A compression rate above 100\/s could be maintained in all studies and hypogravity conditions. Two studies showed a significant reduction of compression depth in 0.38 G (\u22127.2 mm\/\u22128.71 mm) and 0.17 G (\u221212.6 mm\/\u22129.85 mm), respectively, with nearly similar heart rates, compared to 1 G conditions. In the other two studies, participants with higher body weight could maintain a nearly adequate mean depth while effort measured by heart rate (+23\/+13.85 bpm) and VO2max (+5.4 mL\u00b7kg\u22121\u00b7min\u22121) increased significantly; (4) Conclusions: Adequate CPR quality in hypogravity can only be achieved under increased physical stress to compensate for functional weight loss. Without this extra effort, the depth of compression quickly falls below the guideline level, especially for light-weight rescuers. This means faster fatigue during resuscitation and the need for more frequent changes of the resuscitator than advised in terrestrial guidelines. Alternative techniques in the straddling position should be further investigated in hypogravity.<\/jats:p>","DOI":"10.3390\/life12121958","type":"journal-article","created":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T03:15:24Z","timestamp":1669173324000},"page":"1958","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness of CPR in Hypogravity Conditions\u2014A Systematic Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4046-0234","authenticated-orcid":false,"given":"Remco","family":"Overbeek","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"},{"name":"German Society of Aerospace Medicine (DGLRM), 80331 Munich, Germany"},{"name":"Space Medicine Group, European Society of Aerospace Medicine (ESAM), 51149 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Rehnberg","sequence":"additional","affiliation":[{"name":"General Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK"},{"name":"InnovaSpace, London SE28 0LZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yacine","family":"Benyoucef","sequence":"additional","affiliation":[{"name":"Spacemedex, Valbonne Sophia-Antipolis, 06560 Valbonne, France"},{"name":"Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7762-6966","authenticated-orcid":false,"given":"Fabian","family":"Dusse","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1633-4449","authenticated-orcid":false,"given":"Thais","family":"Russomano","sequence":"additional","affiliation":[{"name":"InnovaSpace, London SE28 0LZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3585-9459","authenticated-orcid":false,"given":"Jochen","family":"Hinkelbein","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"},{"name":"German Society of Aerospace Medicine (DGLRM), 80331 Munich, Germany"},{"name":"Space Medicine Group, European Society of Aerospace Medicine (ESAM), 51149 Cologne, Germany"},{"name":"Department of Anesthesiology, Intensive Care Medicine and Emergency Medicine, Johannes-Wesling-Universit\u00e4tsklinikum Minden, Ruhr-Universit\u00e4t Bochum, 32429 Minden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1161\/CIRCOUTCOMES.109.889576","article-title":"Predictors of survival from out-of-hospital cardiac arrest: A systematic review and meta-analysis","volume":"3","author":"Sasson","year":"2010","journal-title":"Circ. 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