Increased frequency of thorax injuries with ACD-CPR

Baubin, Michael; Sumann, Günther; Rabl, Walter; Eibl, Günther; Wenzel, Volker; Mair, Peter

doi:10.1016/s0300-9572(99)00033-7

Cited by 81 publications

(36 citation statements)

References 20 publications

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“…Finally, 13 randomly controlled trials were included into this meta-analysis involving 2 353 CA patients. [11][12][13][14][15][16][17][18][19][20][21][22][23] Thus 1 252 patients accepted ACD-CRP, and 1 252 received S-CRP ( Figure 1). …”

Section: Searching Resultsmentioning

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: Searching Resultsmentioning

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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“…15 With ACD-CPR, the rate of severe thorax injuries was equal or somewhat higher than that of standard CPR. 16 In 1 investigation in cadavers, sternal fractures were found in 11 of 37 cases and rib fractures in 27 of 37 cases at autopsy after ACD-CPR, 17 predominantly in women. In our study, we generally found rib and sternal fractures in a high rate of autopsies (Table 3) with conventional CPR, which corresponds to literature, 15,16,18 and a significantly lower incidence of fractures after Lifestick-CPR.…”

Section: Discussionmentioning

confidence: 97%

Phased Chest and Abdominal Compression-Decompression Versus Conventional Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest

et al. 2001

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Background-Several methods have been developed to improve the efficacy of mechanical resuscitation, because organ perfusion achieved with conventional manual resuscitation is often insufficient. In animal studies, phased chest and abdominal compression-decompression resuscitation by use of the Lifestick device has resulted in a better outcome compared with that of conventional resuscitation. In end-of-life patients, an increased coronary perfusion pressure was achieved. The aim of the present study was to determine the feasibility, safety, and efficacy of the Lifestick compared with conventional resuscitation in patients with sudden nontraumatic out-of-hospital cardiac arrest. Methods and Results-The crews of 4 mobile intensive care units, staffed by an emergency physician and a paramedic, were trained to use the device. Fifty patients were randomized by sealed envelopes to either Lifestick (nϭ24) or conventional (nϭ26) resuscitation. No differences were found regarding demographic and logistical conditions between the groups. Nineteen of the patients (73%) with conventional resuscitation had ventricular fibrillation, 13 of whom survived to hospital admission (no survivals with other arrhythmias) and 7 were discharged. In contrast, in the Lifestick-CPR group, only 9 patients had ventricular fibrillation (38%; PϭϽ0.02; OR, 2.5; 95% CI, 0.6 to 10.6). Four of these 9 patients and 5 of 15 patients with other arrhythmias survived to hospital admission, but none survived to hospital discharge. Autopsy in a subgroup of patients who died at the scene revealed less injuries with Lifestick than with conventional resuscitation. Conclusion-Lifestick

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“…Partly ossified rib cartilages and a consequently stiffer thorax will limit the efficacy of CPAP PSV in this setting. Second, accidental development of a pneumothorax, as may occur during CPR, 17,18 will clearly limit the applicability of CPAP PSV in this setting. Third, optimal CPAP and CPAP PSV levels that manifest in a higher survival rate remain to be determined.…”

Section: Applicability Of Cpap Psv and Critique Of The Methodsmentioning

confidence: 99%

Decompression-Triggered Positive-Pressure Ventilation During Cardiopulmonary Resuscitation Improves Pulmonary Gas Exchange and Oxygen Uptake

et al. 2002

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Background-Intermittent positive-pressure ventilation (IPPV) is the "gold standard" of ventilation during cardiopulmonary resuscitation (CPR), but continuous positive airway pressure (CPAP) is increasingly discussed as an alternative. This study investigated hemodynamics and pulmonary gas exchange applying CPAP enhanced with pressure support ventilation (CPAP PSV ) during CPR. Methods and Results-Twenty-four pigs were subjected to ventricular fibrillation and CPR with CPAP PSV , CPAP, or IPPV. Measurements were taken before (hemodynamics, blood gases, inert gas measurements) and 10 (hemodynamics, blood gases) and 20 (hemodynamics, blood gases, inert gas measurements) minutes after induction of ventricular fibrillation. Although no significant intergroup differences in hemodynamics were found, arterial partial pressure of oxygen (PaO 2 ) was significantly higher during CPAP PSV compared with CPAP or IPPV (98Ϯ10, 61Ϯ27, and 71Ϯ30 mm Hg, respectively, PϽ0.05). CPAP PSV resulted in an alveolar-arterial partial pressure of oxygen difference of 56Ϯ17 mm Hg, whereas during CPAP, 83Ϯ21 mm Hg was detected, and during IPPV, 98Ϯ29 mm Hg was detected (PϽ0.05). Pulmonary blood flow to lung units with a normal V A/Q ratio in percent of cardiac output was 76Ϯ17% during CPAP PSV , 61Ϯ21% during CPAP (PϽ0.01), and 54Ϯ13% during IPPV (PϽ0.01). Oxygen uptake (V O 2 ) was significantly higher during CPAP PSV than with the other ventilation modes (PϽ0.05) and comparable to the baseline value in intragroup comparison. Return of spontaneous circulation was recorded in 8 of 8 animals in the CPAP PSV group, in 6 of 8 in the CPAP group, and in 3 of 8 in the IPPV group. Conclusions-CPAPPSV provides a straightforward and effective alternative to IPPV or CPAP during CPR that provides significantly higher PaO

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Increased frequency of thorax injuries with ACD-CPR

Cited by 81 publications

References 20 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

Phased Chest and Abdominal Compression-Decompression Versus Conventional Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest

Decompression-Triggered Positive-Pressure Ventilation During Cardiopulmonary Resuscitation Improves Pulmonary Gas Exchange and Oxygen Uptake

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