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A correction has been published: N Engl J Med 1999;341(23):1770.
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Background We previously observed that short-term survival after out-of-hospital cardiac arrest was greater with active compression–decompression cardiopulmonary resuscitation (CPR) than with standard CPR. In the current study, we assessed the effects of the active compression–decompression method on one-year survival.
Methods Patients who had cardiac arrest in the Paris metropolitan area or in Thionville, France, more than 80 percent of whom had asystole, were assigned to receive either standard CPR (377 patients) or active compression–decompression CPR (373 patients) according to whether their arrest occurred on an even or odd day of the month, respectively. The primary end point was survival at one year. The rate of survival to hospital discharge without neurologic impairment and the neurologic outcome were secondary end points.
Results Both the rate of hospital discharge without neurologic impairment (6 percent vs. 2 percent, P=0.01) and the one-year survival rate (5 percent vs. 2 percent, P=0.03) were significantly higher among patients who received active compression–decompression CPR than among those who received standard CPR. All patients who survived to one year had cardiac arrests that were witnessed. Nine of 17 one-year survivors in the active compression–decompression group and 2 of 7 in the standard group, respectively, initially had asystole or pulseless electrical activity. In 12 of the 17 survivors who had received active compression–decompression CPR, neurologic status returned to base line, as compared with 3 of 7 survivors who had received standard CPR (P=0.34).
Conclusions Active compression–decompression CPR performed during advanced life support significantly improved long-term survival rates among patients who had cardiac arrest outside the hospital.
Source Information
From the Service Mobile d'Urgence et de Réanimation (SMUR) and the Department of Anesthesiology and Critical Care, Lariboisière University Hospital, Paris (P.P., F.A., D.P.); the Cardiac Arrhythmia Center, University of Minnesota, Minneapolis (K.G.L.); the Biophysics Laboratory, Fernand Widal Hospital, Paris (E.V.); Urgences–SMUR, Thionville Hospital (SMUR 57), Thionville, France (J.-L.P.); Urgences–SMUR, Lagny Hospital (Service d'Aide Médicale Urgente [SAMU] 77), Lagny, France (D.E.); SMUR and the Department of Anesthesiology and Critical Care, La Pitié–Salpétrière University Hospital (SAMU 75), Paris (P.E.); SMUR, Pontoise Hospital (SAMU 95), Pontoise, France (R.G.); SMUR, Montfermeil Hospital (SAMU 93), Montfermeil, France (P.C.); and SMUR, Aulnay-sous-Bois Hospital (SAMU 93), Aulnay-sous-Bois, France (J.B.).
Address reprint requests to Dr. Plaisance at the Department of Anesthesiology and Critical Care, Lariboisière University Hospital, 2 rue Ambroise Paré, 75475 Paris CEDEX 10, France, or at plaisance{at}claranet.fr.
Related Letters:
Active Compression–Decompression Cardiopulmonary Resuscitation
Callaham M., Bubb M. R., Martens P., Plaisance P.
Extract |
Full Text
N Engl J Med 1999;
341:1770-1772, Dec 2, 1999.
Correspondence
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