THE UNITED-KINGDOM PREHOSPITAL STUDY OF ACTIVE COMPRESSION-DECOMPRESSION RESUSCITATION

This prospective, controlled trial with crossover group design compare s the effectiveness of active compression-decompression (ACD) cardiopu lmonary resuscitation (CPR) and standard CPR on the outcomes of victim s of prehospital cardiac arrest. In three UK cities, victims of non-tr aumatic, out of hospital cardiac arrest, over the age of 8 years recei ved either standard or ACD-CPR on arrival of ambulance personnel. Main outcome measures were return of spontaneous circulation, survival to be admitted to the intensive care unit, survival to hospital discharge , and neurological outcome. A total of 576 patients (STD-CPR, n = 309; ACD-CPR, n = 267) were analysed. The treatment groups were similar wi th respect to age, gender, proportion of witnessed arrests, initial ca rdiac rhythm, and call to advanced life support interval. The proporti on of patients receiving bystander CPR was higher in the ACD group (37 .1% vs. 28.5%; P = 0.028). The interval between collapse and defibrill ation was longer in the ACD group (12.3 min vs. 10.4 min; P = 0.028). There was no difference between the STD-CPR and ACD-CPR groups in surv ival to admission to the intensive care unit (13.6% vs. 13.8%; P = 0.9 3) or hospital discharge (4.8% vs. 6.0%; P = 0.67). There was no diffe rence between the groups with respect to the neurological outcome of t hose patients surviving to hospital discharge. Analysis of important s ubgroups also showed no benefit for ACD-CPR. We conclude that there wa s no improvement in outcome with ACD-CPR when used by ambulance person nel in Cardiff and Portsmouth. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.