ACTIVE COMPRESSION-DECOMPRESSION RESUSCITATION - EFFECT ON RESUSCITATION SUCCESS AFTER IN-HOSPITAL CARDIAC-ARREST

Objectives. The purpose of this study was to test the hypothesis that active compression decompression would improve resuscitation success i n human subjects after cardiac arrest. Background. Active compression decompression cardiopulmonary resuscitation is a new method that impro ves cardiopulmonary hemodynamic function in animal models and humans a fter cardiac arrest. Methods. We conducted a prospective randomized cl inical trial in patients with in hospital cardiac arrest. Patients wer e assigned to receive standard manual or active compression-decompress ion cardiopulmonary resuscitation. The primary study end points were s pontaneous return of circulation, 24-h survival and survival to hospit al discharge. Results. Fifty-three consecutive patients after cardiac arrest undergoing 64 resuscitation attempts were studied (30 women, 23 men; mean [+/-SD] age 71 +/- 13 years, range 38 to 96). Spontaneous r eturn of circulation was observed in 24 (47%) of 53 patients and was i ncreased in patients receiving active compression-decompression compar ed with those receiving standard manual cardiopulmonary resuscitation (15 [60%] of 25 vs. 9 [32%] of 28, respectively, p = 0.042); 24-h surv ival was increased (12 [48%] of 25 vs. 6 [21%] of 28, respectively, p = 0.041); and there was a trend toward improved survival to hospital d ischarge (6 [24%] of 25 vs. 3 [11%] of 28, respectively, p = 0.198) wh en active compression decompression was compared with standard manual cardiopulmonary resuscitation. Conclusions. Active compression-decompr ession cardiopulmonary resuscitation improves return of spontaneous ci rculation and 24-h survival after in-hospital cardiac arrest. Active c ompression-decompression cardiopulmonary resuscitation appears to be a beneficial adjunct to standard manual cardiopulmonary resuscitation.