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Previous Volume 329:1918-1921 December 23, 1993 Number 26 Next

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ABSTRACT

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 cardiopulmonary resuscitation (CPR). The purpose of this study was to compare active compression-decompression with standard CPR during cardiac arrests in hospitalized patients.

Methods All patients over the age of 18 years who had a witnessed cardiac arrest while hospitalized at our center were enrolled in this trial; they were randomly assigned according to their medical-record numbers to receive either active compression-decompression or standard CPR. The study end points were the rates of initial resuscitation, survival at 24 hours, hospital discharge, and neurologic outcome. Compressions were performed according to the recommendations of the American Heart Association (80 to 100 compressions 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 underwent 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 percent of patients who underwent standard CPR (P<0.004). Two of the 62 study patients survived to hospital discharge; both were randomly assigned 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 with standard CPR, active compression-decompression CPR improved the rate of initial resuscitation, survival at 24 hours, and neurologic outcome after in-hospital cardiac arrest. Larger trials will be required to assess the potential benefit in terms of long-term survival.

Source Information

Presented as part of the 1993 Courmand & Comroe Young Investigator Award Competition at the 66th Scientific Session of the American Heart Association, Atlanta, November 8, 1993.

From the Electrophysiology Section, Department of Medicine, North Shore University Hospital-Cornell University Medical College, 300 Community Dr., Manhasset, NY 11030, where reprint requests should be addressed to Dr. Todd Cohen.

Full Text of this Article

Related Letters:

Active Compression-Decompression Cardiopulmonary Resuscitation
Stone P. G., Sachs F. L., Cohen T. J.
Extract | Full Text  
N Engl J Med 1994; 330:1391, May 12, 1994. Correspondence

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