ACTIVE COMPRESSION-DECOMPRESSION CARDIOPULMONARY-RESUSCITATION (ACD-CPR) COMPARED WITH STANDARD CPR IN A MANNEQUIN MODEL - DECOMPRESSION FORCE, COMPRESSION RATE, DEPTH AND DURATION

During active compression-decompression cardiopulmonary resuscitation (ACD-CPR), the rescuer applies traction to the chest between compressi ons. Under experimental conditions, cardiac output increases, possibly through accentuated intrathoracal pressure fluctuations. ACD-CPR requ ires specific training and may be more complex to perform than standar d CPR. The aim of this study was to characterize ACD-CPR performance c ompared with standard CPR by emergency care providers; in terms of dec ompression force, compression rate, depth and duration. Thirty-three a mbulance paramedics were studied while performing standard CPR and ACD -CPR with the Ambu Cardiopump(R) on a specially designed transducer-eq uipped manikin 9 months following initial training. The order of CPR p erformance was determined randomly by cross-over design. Performance d ata were recorded by a computer. The 2-min average active decompressio n force was 9.3 kg (interquartile range 2.5-15.3 kg) and six subjects (18%) mel the manufacturers recommendation of 10-15 kg. External chest compression (ECC) rate decreased from 85 (70-101) to 76 (63-88) min(- 1) (P < 0.001), ECC depth decreased from 54 (50-58) to 45 (39-48) mm ( P < 0.001) and compression duration from 40 (35-45) to 31% (28-33%) P < 0.001) upon change from standard CPR to ACD-CPR. We conclude that th e recommended level of decompression force was achieved by less than o ne fifth of study subjects. ACD-CPR when compared with standard CPR ca uses a consistent and significant reduction of compression rate, depth and duration. These are all factors of possible clinical significance . Training in ACD-CPR should address this issue, with special emphasis on optimal decompression force and ECC rate. (C) 1997 Elsevier Scienc e Ireland Ltd.