Evaluation of standard and active compression-decompression CPR in an acute human model of ventricular fibrillation.

Shultz, Jeffrey J.; Coffeen, Paul; Sweeney, Michael F.; Detloff, Barry L.S.; Kehler, C. H.; Pineda, Edgar; Yakshe, Paul N.; Adler, Stuart W.; Chang, Mark W.; Lurie, Keith G.

doi:10.1161/01.cir.89.2.684

Cited by 134 publications

(38 citation statements)

References 44 publications

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“…During ACD-CPR, positive and negative pressures are used alternately to the chest by a "plunger" that forms a seal with the anterior chest wall. Several studies found that ACD-CPR produced better hemodynamic effects than standard CPR in patients, [27][28][29] but there were exceptions. [30] The results of this meta-analysis indicate that ACD-CPR is superior to STD-CPR for CA patients in terms of ROSC rate, survival rate at 24 hours, and admission rate.…”

Section: Discussionmentioning

confidence: 99%

Active compression-decompression cardiopulmonary resuscitation (CPR) versus standard CPR for cardiac arrest patients: a meta-analysis

Luo

Zhang

Chen

et al. 2013

World Journal of Emergency Medicine

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BACKGROUND: Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) has been popular in the treatment of patients with cardiac arrest (CA). However, the effect of ACD-CPR versus conventional standard CPR (S-CRP) is contriversial. This study was to analyze the effi cacy and safety of ACD-CPR versus S-CRP in treating CA patients. METHODS:Randomized or quasi-randomized controlled trials published from January 1990 to March 2011 were searched with the phrase "active compression-decompression cardiopulmonary resuscitation and cardiac arrest" in PubMed, EmBASE, and China Biomedical Document Databases. The Cochrane Library was searched for papers of meta-analysis. Restoration of spontaneous circulation (ROSC) rate, survival rate to hospital admission, survival rate at 24 hours, and survival rate to hospital discharge were considered primary outcomes, and complications after CPR were viewed as secondary outcomes. Included studies were critically appraised and estimates of effects were calculated according to the model of fi xed or random effects. Inconsistency across the studies was evaluated using the I 2 statistic method. Sensitivity analysis was made to determine statistical heterogeneity. RESULTS:Thirteen studies met the criteria for this meta-analysis. The studies included 396 adult CA patients treated by ACD-CPR and 391 patients by S-CRP. Totally 234 CA patients were found out hospitals, while the other 333 CA patients were in hospitals. Two studies were evaluated with high-quality methodology and the rest 11 studies were of poor quality. ROSC rate, survival rate at 24 hours and survival rate to hospital discharge with favorable neurological function indicated that ACD-CPR is superior to S-CRP, with relative risk (RR) values of 1.39 (95% CI 0.99-1.97), 1.94 (95% CI 1.45-2.59) and 2.80 (95% CI 1. 60-5.24). No significant differences were found in survival rate to hospital admission and survival rate to hospital discharge for ACD-CPR versus S-CRP with RR values of 1.06 (95% CI 0.76-1.60) and 1.00 (95% CI 0.73-1.38).CONCLUSION: Quality controlled studies confirmed the superiority of ACD-CPR to S-CRP in terms of ROSC rate and survival rate at 24 hours. Compared with S-CRP, ACD-CPR could not improve survival rate to hospital admission or survival rate to hospital discharge.

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Section: Discussionmentioning

confidence: 99%

Active compression-decompression cardiopulmonary resuscitation (CPR) versus standard CPR for cardiac arrest patients: a meta-analysis

Luo

Zhang

Chen

et al. 2013

World Journal of Emergency Medicine

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“…Die Reduktion des intrathorakalen Drucks während der Entlastungsphase erhöht den venösen Rückstrom zum Herzen und somit das Herzzeitvolumen sowie nachfolgend den koronaren und zerebralen Perfusionsdruck in der Kompressionsphase [541,542,543,544]. Die Ergebnisse von ACD-CPR waren divergierend.…”

Section: Reanimatiom Mithilfe Aktiver Kompression-dekompressionunclassified

“…Die Ergebnisse von ACD-CPR waren divergierend. In einigen klinischen Studien verbesserte ACD-CPR im Vergleich zur manuellen CPR die Hämodynamik [542,544,545,546], in anderen dagegen nicht [547]. In 3 randomisierten Studien [546,548,549] verbesserte die ACD-CPR das Langzeit-Outcome nach präklinischem Kreislaufstillstand; in 5 anderen randomisierten Studien führte ACD-CPR zu keiner Verbesserung des Outcome [550,551,552,553,554].…”

Section: Reanimatiom Mithilfe Aktiver Kompression-dekompressionunclassified

Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)

Deakin

Nolan

Soar

et al. 2010

Notfall Rettungsmed

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“…Active compression-decompression CPR (ACD-CPR) has been shown to increase cardiac output compared with standard CPR in adult animal models. 266,267 ACD-CPR maintains coronary perfusion during compression and decompression in humans 268,269 and provides ventilation if the airway is patent. 268,270 In clinical trials ACD-CPR has produced variable results, including improved short-term outcome (eg, return of spontaneous circulation and survival for 24 hours).…”

Section: Circulatory Adjuncts and Mechanical Devices For Chest Comprementioning

confidence: 99%

“…266,267 ACD-CPR maintains coronary perfusion during compression and decompression in humans 268,269 and provides ventilation if the airway is patent. 268,270 In clinical trials ACD-CPR has produced variable results, including improved short-term outcome (eg, return of spontaneous circulation and survival for 24 hours). [271][272][273][274] However, these improved outcomes are not consistent, 275 and no long-term survival benefits of ACD-CPR have been reported in most trials.…”

Section: Circulatory Adjuncts and Mechanical Devices For Chest Comprementioning

confidence: 99%

Part 9: Pediatric Basic Life Support

2000

Circulation

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• The extremely complex skills sequence for lay rescuer relief of foreign-body airway obstruction (FBAO) in the unconscious victim has been simplified. The sequence for healthcare provider relief of FBAO in the unconscious victim remains unchanged (Class IIb). IntroductionPediatric BLS refers to the provision of CPR, with no devices or with bag-mask ventilation or barrier devices, until advanced life support (ALS) can be provided. The population addressed in this chapter includes infants from birth to 1 year of age and children from 1 to 8 years of age. CPR and life support in the pediatric age group should be part of a community-wide Chain of Survival that links the child to the best hope of survival following emergencies. The Chain of Survival integrates education in prevention of cardiopulmonary arrest, BLS, early access to EMS systems prepared for children's needs, early and effective pediatric Sudden cardiopulmonary arrest in infants and children is much less common than sudden cardiac arrest in adults. 4 In contrast to cardiac arrest in adults, cardiac arrest in infants and children is rarely a sudden event, and non-cardiac causes predominate. 4 The etiology of cardiac arrest in infants and children varies by age, setting, and the underlying health of the child. For these reasons, the sequence of CPR for infants and children requires a different approach from that used for adult victims.Cardiac arrest in the under-21-year-old age group occurs most commonly at either end of the age spectrum: under 1 year of age and during the teenage years. In the newly born infant, respiratory failure is the most common cause of cardiopulmonary deterioration and arrest. During infancy the most common causes of arrest include sudden infant death syndrome (SIDS), respiratory diseases, airway obstruction (including foreign-body aspiration), submersion, sepsis, and neurological disease. [5][6][7][8][9][10][11] Beyond 1 year of age, injuries are the leading cause of death. [12][13][14] Cardiac arrest in children typically represents the terminal event of progressive shock or respiratory failure. Either shock or respiratory failure may include a compensated state from which children can rapidly deteriorate to a decompensated condition with progression to respiratory or cardiac arrest. Therefore, rescuers must detect and promptly treat early signs of respiratory and circulatory failure to prevent cardiac arrest. In children, early effective bystander CPR has been associated with successful return of spontaneous circulation and neurologically intact survival. 15,16 BLS courses should be offered to target populations such as expectant parents, child care providers, teachers, sports supervisors, and others who regularly care for children. Parents and child care providers of children with underlying conditions that predispose them to cardiopulmonary failure should be particularly targeted for these courses.These guidelines are based on a review and analysis of clinical and experimental evidence. 17 Because this evidence varies widely...

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Evaluation of standard and active compression-decompression CPR in an acute human model of ventricular fibrillation.

Cited by 134 publications

References 44 publications

Active compression-decompression cardiopulmonary resuscitation (CPR) versus standard CPR for cardiac arrest patients: a meta-analysis

Active compression-decompression cardiopulmonary resuscitation (CPR) versus standard CPR for cardiac arrest patients: a meta-analysis

Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)

Part 9: Pediatric Basic Life Support

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