Pre-hospital IAC-CPR versus standard CPR: Paramedic resuscitation of cardiac arrests

Mateer, James R; Stueven, Harlan A; Thompson, Bruce; Aprahamian, Charles; Darin, Joseph C.

doi:10.1016/0735-6757(85)90038-5

Cited by 105 publications

(61 citation statements)

References 16 publications

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“…Acute hemodynamics (BP, ETCO 2  crossover) [33][34][35][36][37][38][39] All arrests (mostly VF) 1,40 Difficult arrests (EMD, asystole, prolonged) 41,42 For most end points results for IAC-CPR were between 1.5 and 2.0 times those for comparable standard CPR without abdominal compression.…”

Section: Model Class Subtypes Resultsmentioning

confidence: 99%

“…This limitation would preclude IAC-CPR in those systems, either limiting benefit, or increasing cost dramatically if a third paid rescuer were included on ambulances. This limitation was first noted by Mateer et al 40 , who could not do IAC-CPR during transport of patients in their initial out-of hospital study. For this reasons it would seem prudent to limit initial clinical implementation of IAC-CPR to use by professional rescuers in hospitals.…”

Section: Cost Versus Benefitmentioning

confidence: 98%

“…One randomized trial of pre-hospital IAC-CPR, combined when possible with standard CPR in the field, showed no difference in outcome or in complications 53 . These clinical trials are summarized in Table 4.…”

Section: Efficacy Of Iac-cprmentioning

confidence: 99%

“…These include all available survival data from the three in-hospital trials and one and outof-hospital trial 1,33,40,41 . That is, hemodynamic data were not considered.…”

Section: Meta-analysismentioning

confidence: 99%

“…Since IAC requires no new equipment or drug, its added cost is minimal, as long as adequate personnel are available in the hospital setting. However, as initially discovered by Mateer and coworkers 40 , lack of trained personnel in out-of-hospital settings can obviate the use of IAC-CPR. Short reviews of the issues of complexity, cost vs. benefit, and pedagogy are as follows.…”

Section: Implementation Issuesmentioning

confidence: 99%

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Interposed abdominal compression CPR: a comprehensive evidence based review

Babbs

2003

Resuscitation

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Interposed abdominal compression (IAC)-CPR includes all steps of standard external CPR with the addition of manual mid-abdominal compressions in counterpoint to the rhythm of chest compressions. IAC-CPR can increase blood flow during CPR about two fold compared to standard CPR without IAC, as shown by 6 of 6 studies in computer models and 19 of 20 studies in various animal models. The addition of IAC has clinical benefit in humans, as indicated in 10 of 12 small to medium sized clinical studies. The technique increases the frequency of immediate return of spontaneous circulation for in-hospital resuscitations from roughly 25% to 50%. Improved survival to discharge is also likely on the basis of two small in-hospital trials. Possible harm from abdominal compression is minimal on the basis of 426 humans, 151, dogs and 14 pigs that received IAC in published reports. The complexity of performing IAC is similar to that of opening the airway and is less than that of other basic life support maneuvers. The aggregate evidence suggests that IAC-CPR is a safe and effective means to increase organ perfusion and survival, when performed by professionally trained responders in a hospital and when initiated early in the resuscitation protocol. Cost and logistical considerations discourage use of IAC-CPR outside of hospitals.

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Section: Model Class Subtypes Resultsmentioning

confidence: 99%

Section: Cost Versus Benefitmentioning

confidence: 98%

Section: Efficacy Of Iac-cprmentioning

confidence: 99%

“…These include all available survival data from the three in-hospital trials and one and outof-hospital trial 1,33,40,41 . That is, hemodynamic data were not considered.…”

Section: Meta-analysismentioning

confidence: 99%

Section: Implementation Issuesmentioning

confidence: 99%

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