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

Abstract

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

How Sudden Is Sudden Cardiac Death?

“…A detailed description has been given elsewhere of the 2-tiered emergency system (EMS): a first-tier ambulance with emergency medical technicians on board equipped with automated external defibrillators (AEDs) and a second tier manned with an emergency physician. 10 On the basis of a questionnaire evaluated in a pilot study, all available bystanders and witnesses of the arrest were interviewed on site by the emergency physician. This questionnaire was used to obtain data on the logistics of EMS and demographics, as well as the patient's medical history, medication use, and any preceding signs or symptoms and their duration.…”

Mechanical Chest Compression Devices: Historical Evolution, Classification and Current Practices, A Short Review

“…In a study that consisted of a small series of cases, X-CPR produced higher coronary perfusion pressure than S-CPR (42). In a study with the Lifestick, a phased thoracic-abdominal active compression-decompression CPR device, no difference was detected compared with S-CPR in terms of ROSC, but it was reported that this technique could be advantageous for patients with asystole or pulseless electrical activity (48). Another study conducted with a small sample (49) did not report any statistically significant difference between using the Lifestick and applying S-CPR.…”

“…The larger adhesive pad is placed over the abdomen and the smaller over the anterior chest wall. An implementer compresses the two sides of the device just like a seesaw, applying pressure both on the chest and the abdomen alternately ( Figure 5b) (11,27,(48)(49)(50).…”

Die neuen Reanimationsleitlinien 2005 des European Resuscitation Council

“…Tierexperimentelle Untersuchungen zeigten Vorteile dieser Technik [162]. In einer klinischen Untersuchung konnte die Überlebenschan-ce jedoch nicht verbessert werden [19]. Mithilfe druckluftbetriebener mechanischer Geräte (Thumper®) zur Durchführung von Thoraxkompressionen konnte eine Verbesserung der Hämody-namik in CPR-Laborstudien gezeigt werden.…”