Active compression-decompression versus standard cardiopulmonary resuscitation in a porcine model: no improvement in outcome.
Active compression-decompression cardiopulmonary resuscitation (CPR) is a new innovative basic life-support technique during which the anterior chest wall is actively decompressed by a suction device. CPR techniques were studied in 36 swine to test the hypothesis that active compression-decompression CPR improves coronary perfusion pressure, myocardial blood flow during CPR, and 24-hour survival. After 30 seconds of untreated ventricular fibrillation, CPR was begun and continued for 12.5 minutes by one of the three following methods: (1) active compression-decompression CPR with a suction device modified to include a precision force transducer; (2) standard CPR performed with a force transducer device; and (3) standard manual CPR performed without a force transducer device. CPR-generated coronary perfusion pressure, myocardial blood flow, and the force of compression were measured at 3 and 10 minutes of resuscitation effort. Initial return of spontaneous circulation, 24-hour survival, and trauma scores were also evaluated. Active compression-decompression CPR produced consistently better results than did standard CPR performed with a force transducer, but not better than standard CPR performed manually without a force transducer. The use of a force-measuring device with standard CPR may compromise hemodynamic response and outcome.
Kern
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KB
Department of Medicine, University of Arizona College of Medicine, Tucson 85724, USA.
Figge
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Hilwig
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Sanders
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Berg
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Otto
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Ewy
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D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000379:methods*; D003326:Coronary Circulation; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005260:Female; D006439:Hemodynamics; D008297:Male; D013552:Swine; D016896:Treatment Outcome