A randomized clinical trial of active compression-decompression CPR vs standard CPR in out-of-hospital cardiac arrest in two cities

Article Abstract:

Active compression-decompression (ACD) cardiopulmonary resuscitation (CPR) does not appear to be more effective than standard CPR in the prehospital treatment of patients in cardiac arrest. In ACD CPR, a hand-held suction device is applied to and withdrawn from the patient's chest. Emergency medical personnel in Fresno, CA, and San Francisco, CA, performed ACD CPR on 414 cardiac arrest patients and standard CPR on 446 cardiac arrest patients. Similar numbers of patients in both treatment groups had a return of spontaneous circulation before hospital arrival. The rate and average length of hospitalization, the rate of hospital discharge, and the average cerebral and functional abilities at discharge were also similar between both treatment groups. Of the 128 patients who received medical attention within 10 minutes after cardiac arrest, patient outcomes were similar in ACD CPR recipients and in those who received standard CPR. The incidence of complications did not differ according to CPR technique.

Evaluation

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Active compression-decompression: a new method of cardiopulmonary resuscitation

Article Abstract:

A mechanical device that allows doctors to decompress the chest actively during cardiopulmonary resuscitation (CPR) rather than passively may be more effective in restoring heart function in patients who are in cardiac arrest. This device was used on 10 patients in cardiac arrest who had received conventional care for at least 10 minutes. Each patient was randomized to receive either CPR with an active compression-decompression (ACD) device or traditional CPR for two minutes; then they were switched to the alternate method. Blood pressure in eight patients increased significantly when they were switched from CPR to ACD-CPR. Doppler echocardiography during ACD-CPR showed that blood flow from the heart increased, compared to CPR. The echocardiogram also showed that the mitral valve, which controls the flow of blood into the left ventricle, opened much more widely during the relaxation phase of ACD-CPR, compared to CPR. ACD-CPR restored a stable rhythm in three of the patients, but none survived.

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A comparison of standard cardiopulmonary resuscitation and active compression-decompression resuscitation for out-of-hospital cardiac arrest

Article Abstract:

People in cardiac arrest who receive active compression-decompression cardiopulmonary resuscitation (CPR) are more likely to survive than those who receive standard CPR. During active compression-decompression CPR, a hand-held suction device is used to raise the chest in between compressions. This allows more blood to flow through the heart. Researchers randomly assigned 750 patients in cardiac arrest to receive standard CPR or active compression-decompression CPR. Those who received active compression-decompression CPR were twice as likely to be alive one year later and also more likely to recover neurologic function.

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