A COMPARISON OF ACTIVE COMPRESSION-DECOMPRESSION CARDIOPULMONARY-RESUSCITATION WITH STANDARD CARDIOPULMONARY-RESUSCITATION FOR CARDIAC ARRESTS OCCURRING IN THE HOSPITAL

Background. Recent studies have demonstrated improved cardiopulmonary circulation during cardiac arrest with the use of a hand-held suction device (Ambu CardioPump) to perform active compression-decompression c ardiopulmonary resuscitation (CPR). The purpose of this study was to c ompare active compression-decompression with standard CPR during cardi ac arrests in hospitalized patients. Methods. All patients over the ag e of 18 years who had a witnessed cardiac arrest while hospitalized at our center were enrolled in this trial; they were randomly assigned a ccording to their medical-record numbers to receive either active comp ression-decompression or standard CPR. The study end points were the r ates of initial resuscitation, survival at 24 hours, hospital discharg e, and neurologic outcome. Compressions were performed according to th e recommendations of the American Heart Association (80 to 100 compres sions per minute; depth of compression, 3.8 to 5.1 cm [1.5 to 2 in.]; and 50 percent of the cycle spent in compression). Results. Sixty-two patients (45 men and 17 women) with a mean age (+/-SE) of 68+/-2 years were entered into the trial. Sixty-two percent of the patients who un derwent active compression-decompression were initially resuscitated, as compared with 30 percent of the patients who received standard CPR (P<0.03); 45 percent of the patients who underwent active compression- decompression survived for at least 24 hours, as compared with 9 perce nt of patients who underwent standard CPR (P<0.004). Two of the 62 stu dy patients survived to hospital discharge; both were randomly assigne d to receive active compression-decompression. Neurologic outcome, as measured by the Glasgow coma score, was better with active compression -decompression (8.0+/-1.3) than with standard CPR (3.5+/-0.3; P<0.02). Conclusions. In this preliminary study, we found that, as compared wi th standard CPR, active compression-decompression CPR improved the rat e of initial resuscitation, survival at 24 hours, and neurologic outco me after in-hospital cardiac arrest. Larger trials will be required to assess the potential benefit in terms of long-term survival.