title: Active decompression improves the haemodynamic state during cardiopulmonary resuscitation.
abstract: OBJECTIVE
  To examine whether use of the active compression-decompression device improves the haemodynamics of cardiopulmonary resuscitation compared with those of conventional cardiopulmonary resuscitation.
  
  
  METHODS
  Prospective crossover study.
  
  
  METHODS
  The accident and emergency department of a university teaching hospital.
  
  
  METHODS
  36 adult patients with non-traumatic, normothermic, out of hospital cardiac arrest.
  
  
  METHODS
  Cardiopulmonary resuscitation was performed during resuscitation in alternating 3 min cycles of conventional and active compression-decompression cardiopulmonary resuscitation.
  
  
  METHODS
  The end tidal carbon dioxide (ETCO2), femoral arterial pressure, and acid-base analysis of central venous blood measured during the last 30 s of each 3 minute cardiopulmonary resuscitation cycle.
  
  
  RESULTS
  ETCO2 was monitored in 36 patients during conventional and active compression-decompression cardiopulmonary resuscitation. Active compression-decompression cardiopulmonary resuscitation caused a significant increase in ETCO2 (P < 0.0002), indicating improved cardiac output. Arterial pressure measurement was carried out in 10 patients. Systolic pressure was significantly greater with active compression-decompression than conventional cardiopulmonary resuscitation (P < 0.007). Central venous blood was taken for acid-base analysis in 11 patients. There was a significant increase in the central venous hydrogen ion concentration (P = 0.025) with rises in the partial pressures of carbon dioxide and oxygen, suggesting improved venous return.
  
  
  CONCLUSIONS
  This study confirms that active compression-decompression cardiopulmonary resuscitation is associated with better haemodynamic status than conventional resuscitation.
authors.affiliation: Department of Accident and Emergency Medicine, Royal Infirmary of Edinburgh.
authors.forename: U M
authors.initials: UM
authors.lastname: Guly
authors.forename: C E
authors.initials: CE
authors.lastname: Robertson
mesh_terms: D000136:Acid-Base Equilibrium; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002302:Cardiac Output; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006323:Heart Arrest / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies