title: Active compression-decompression resuscitation: effect on resuscitation success after in-hospital cardiac arrest.
abstract: OBJECTIVE
  The purpose of this study was to test the hypothesis that active compression-decompression would improve resuscitation success in human subjects after cardiac arrest.
  
  
  BACKGROUND
  Active compression-decompression cardiopulmonary resuscitation is a new method that improves cardiopulmonary hemodynamic function in animal models and humans after cardiac arrest.
  
  
  METHODS
  We conducted a prospective randomized clinical trial in patients with in-hospital cardiac arrest. Patients were assigned to receive standard manual or active compression-decompression cardiopulmonary resuscitation. The primary study end points were spontaneous return of circulation, 24-h survival and survival to hospital 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 return of circulation was observed in 24 (47%) of 53 patients and was increased in patients receiving active compression-decompression compared with those receiving standard manual cardiopulmonary resuscitation (15 [60%] of 25 vs. 9 [32%] of 28, respectively, p = 0.042); 24-h survival 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 discharge (6 [24%] of 25 vs. 3 [11%] of 28, respectively, p = 0.198) when active compression-decompression was compared with standard manual cardiopulmonary resuscitation.
  
  
  CONCLUSIONS
  Active compression-decompression cardiopulmonary resuscitation improves return of spontaneous circulation and 24-h survival after in-hospital cardiac arrest. Active compression-decompression cardiopulmonary resuscitation appears to be a beneficial adjunct to standard manual cardiopulmonary resuscitation.
authors.affiliation: Mount Zion Medical Center, University of California, San Francisco.
authors.forename: K J
authors.initials: KJ
authors.lastname: Tucker
authors.forename: F
authors.initials: F
authors.lastname: Galli
authors.forename: M A
authors.initials: MA
authors.lastname: Savitt
authors.forename: D
authors.initials: D
authors.lastname: Kahsai
authors.forename: L
authors.initials: L
authors.lastname: Bresnahan
authors.forename: R F
authors.initials: RF
authors.lastname: Redberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002138:Calibration; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012107:Research Design; D012495:San Francisco / Q000453:epidemiology; D016019:Survival Analysis