COMPARISON OF EXERTION REQUIRED TO PERFORM STANDARD AND ACTIVE COMPRESSION-DECOMPRESSION CARDIOPULMONARY-RESUSCITATION

Objective: Active compression-decompression (ACD) cardiopulmonary resu scitation (CPR) utilizes a hand-held suction device with a pressure ga uge that enables the operator to compress as well as actively decompre ss the chest. This new CPR method improves hemodynamic and ventilatory parameters when compared with standard CPR. ACD-CPR is easy to perfor m but may be more labor intensive, The purpose of this study was to qu antify and compare the work required to perform ACD and standard CPR. Methods: Cardiopulmonary testing was performed on six basic cardiac li fe support- and ACD-trained St. Paul, MN fire-fighter personnel during performance of 10 min each of ACD and standard CPR on a mannequin equ ipped with a compression gauge. The order of CPR techniques was determ ined randomly with >1 h between each study. Each CPR method was perfor med at 80 compressions/min (timed with a metronome), to a depth of 1.5 -2 inches, and with a 50% duty cycle. Results: Baseline cardiopulmonar y measurements were similar at rest prior to performance of both CPR m ethods. During standard and ACD-CPR, respectively, rate-pressure produ ct was 18.2 +/- 3.0 vs, 23.8 +/- 1.7 (x 1000, P < 0.01); mean oxygen c onsumption 15.98 +/- 2.29 vs, 20.07 +/- 2.10 ml/kg/min or 4.6 +/- 0.7 vs, 5.7 +/- 0.6 METS (P < 0.01); carbon dioxide production 1115.7 +/- 110 vs. 1459,1 +/- 176 ml/min; respiratory exchange ratio 0.88 +/- 0.0 4 vs, 0.92 +/- 0.04 (P = NS); and minute ventilation 35.5 +/- 5.1 vs. 45.6 +/- 9.2 l/min (P < 0.01). Conclusions: Approximately 25% more wor k is required to perform ACD-CPR compared with standard CPR. Both meth ods require subanaerobic energy expenditure and can therefore be susta ined for a sufficient length of time by most individuals to optimize r esuscitation efforts. Due to the slightly higher work requirement, ACD -CPR may be more difficult to perform compared with standard CPR for l ong periods of time, particularly by individuals unaccustomed to the w orkload requirement of CPR, in general.