END-TIDAL CARBON-DIOXIDE DURING OUT-OF-HOSPITAL CARDIAC-ARREST RESUSCITATION - COMPARISON OF ACTIVE COMPRESSION-DECOMPRESSION AND STANDARD CPR

Study objectives: To compare the maximal end-tidal carbon dioxide pres sure (ETCO2 peak) values obtained during standard (S-CPR) and active c ompression-decompression CPR (ACD-CPR) during prolonged resuscitation in out-of-hospital cardiac arrest. Design: Prospective, randomized cro ssover study. Setting: City with a population of 3.5 million, served b y an emergency medical service system providing advanced cardiac life support. Participants: Patients with nontraumatic out-of-hospital card iac arrest. Interventions: Patients were randomly assigned to receive first, for a period of 3 minutes, either ACD-CPR or S-CPR; then the tw o methods were alternated. ETCO2 was continuously monitored and comput ed. Measurements and Results: Sixteen patients (48+/-20 years old) wer e included; in 12, return of spontaneous circulation was achieved, and 5 were admitted alive to the hospital. A statistically significant in crease in ETCO2 peak was obtained with ACD-CPR (27.6+/-3 mm Hg) compar ed with S-CPR (15.6+/-2.2 mm Hg). No major adverse effect possibly rel ated to ACD-CPR was observed. Conclusion: This prospective study sugge sts that ACD-CPR may improve cardiac output compared with S-CPR.