Mechanical active compression-decompression versus standard mechanical cardiopulmonary resuscitation: A randomised haemodynamic out-of-hospital cardiac arrest study.
ACD-CPR
Active compression decompression
Capnography
Cardiac arrest
Cardiopulmonary resuscitation
Cerebral oximetry
ETCO(2)
Haemodynamic
Invasive arterial blood pressure
Mechanical chest compression
NIRS
SctO(2)
rSO(2)
Journal
Resuscitation
ISSN: 1873-1570
Titre abrégé: Resuscitation
Pays: Ireland
ID NLM: 0332173
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
11
05
2021
revised:
13
10
2021
accepted:
15
10
2021
pubmed:
29
10
2021
medline:
25
3
2022
entrez:
28
10
2021
Statut:
ppublish
Résumé
Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) utilises a suction cup to lift the chest-wall actively during the decompression phase (AD). We hypothesised that mechanical ACD-CPR (Intervention), with AD up to 30 mm above the sternal resting position, would generate better haemodynamic results than standard mechanical CPR (Control). This out-of-hospital adult non-traumatic cardiac arrest trial was prospective, block-randomised and non-blinded. We included intubated patients with capnography recorded during mechanical CPR. Exclusion criteria were pregnancy, prisoners, and prior chest surgery. The primary endpoint was maximum tidal carbon dioxide partial pressure (p Of 221 enrolled patients, 210 were deemed eligible (Control 109, Intervention 101). The Control vs. Intervention results showed no significant differences for p Mechanical ACD-CPR provided similar haemodynamic results to standard mechanical CPR. The Intervention device did not consistently provide Complete AD. ClinicalTrials.gov identifier (NCT number): NCT02479152. The Haemodynamic Effects of Mechanical Standard and Active Chest Compression-decompression During Out-of-hospital CPR.
Sections du résumé
BACKGROUND
Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) utilises a suction cup to lift the chest-wall actively during the decompression phase (AD). We hypothesised that mechanical ACD-CPR (Intervention), with AD up to 30 mm above the sternal resting position, would generate better haemodynamic results than standard mechanical CPR (Control).
METHODS
This out-of-hospital adult non-traumatic cardiac arrest trial was prospective, block-randomised and non-blinded. We included intubated patients with capnography recorded during mechanical CPR. Exclusion criteria were pregnancy, prisoners, and prior chest surgery. The primary endpoint was maximum tidal carbon dioxide partial pressure (p
RESULTS
Of 221 enrolled patients, 210 were deemed eligible (Control 109, Intervention 101). The Control vs. Intervention results showed no significant differences for p
CONCLUSIONS
Mechanical ACD-CPR provided similar haemodynamic results to standard mechanical CPR. The Intervention device did not consistently provide Complete AD.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov identifier (NCT number): NCT02479152. The Haemodynamic Effects of Mechanical Standard and Active Chest Compression-decompression During Out-of-hospital CPR.
Identifiants
pubmed: 34710550
pii: S0300-9572(21)00433-0
doi: 10.1016/j.resuscitation.2021.10.026
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT02479152']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-10Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest LW was PI in the Zoll Medical funded CIRC study and holds patents via Oslo University Hospital (Inven2). He is a member of the medical advisory board of Stryker/Physio-Control. At the time of the study, BMH was employed by Stryker/Jolife AB, which manufactures the LUCAS device, LIFEPAK 15 and CODE-STAT. In addition, JC did analysis and data work for the study that was funded by Stryker/Jolife AB. POB, TS, HK and JKJ declare no conflicts of interests.