BENEFIT OF ACTIVE COMPRESSION-DECOMPRESSION CARDIOPULMONARY-RESUSCITATION AS A PREHOSPITAL ADVANCED CARDIAC LIFE-SUPPORT - A RANDOMIZED MULTICENTER STUDY

Background We compared short-term prognosis of active compression-deco mpression (ACD) and standard (STD) cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrests. Methods and Results We randomized advanced cardiac life support (ACLS) with ACD ACLS CPR on odd days an d STD ACLS CPR on even days. We measured the rates of return of sponta neous circulation (ROSC), survival at 1 hour (H-1), at 24 hours (H-24) , and at 1 month (D-30); hospital discharge (HD); neurological outcome ; and complications. Mean times from collapse to basic cardiac life su pport CPR was 9 minutes and from collapse to ACLS CPR was 21 minutes. Compared with the STD ACLS patients (n=258), ACD ACLS patients (n=254) had higher survival rates (ROSC, 44.9% versus 29.8%, P=.0004; H-1, 36 .6% versus 24.8%, P=.003; H-24, 26% versus 13.6%, P=.002; HD without n eurological impairment, 5.5% versus 1.9%, P=.03) and a trend for impro vement in neurological outcome at D-30 (Glasgow-Pittsburgh Outcome Cat egories=1.6+/-0.8 versus 2.3+/-1.1, P=.09). Sternal dislodgments (2.9% versus 0.4%, P=.03) and hemoptysis (5.4% Versus 1.3%, P=.01) were mor e frequent in the ACD ACLS group. Conclusions Despite longtime interva ls, ACD significantly improved shea-term survival rates in out-of-hosp ital cardiac arrests compared with STD CPR.