[Active compression-decompression resuscitation. Improved survival rate in an emergency medicine system with emergency physician assistance?].
BACKGROUND
Improved cardiopulmonary circulation with active compression-decompression resuscitation (ACD-CPR) has been demonstrated in studies using different animal models and a small number of human in cardiac arrest (CA). However, prehospital studies have shown both positive and no extra benefit of ACD-CPR on survival rates and neurologic outcome.


METHODS
The aim of our prospective study was to compare standard manual CPR (S-CPR) to ACD-CPR as the initial technique of resuscitating patients with out-of-hospital CA with respect to survival rates and neurological outcome in our two-tiered EMS system with physicians in the field.


RESULTS
Patients with out-of-hospital CA treated by emergency medical services (EMS) personnel were randomly assigned to 1 of 2 groups (ACD-CPR versus S-CPR). The treatment groups were similar with respect to age, sex, time interval from collapse to CPR, defibrillation and first epinephrine medication. There was no difference between the ACD group and the standard CPR group in terms of survival rates and neurologic outcome. No differences occurred concerning complications of CPR.


CONCLUSIONS
In our two-tiered EMS system with physician-staffed ambulances ACD-CPR neither improved nor impaired the survival rates and the neurological prognosis in patients with out-of-hospital cardiac arrest. Our results are in accordance with other studies carried out in EMS systems, with first tier call-response intervals between 4 and 6 min.
Mauer
D
D
Klinik für Anästhesiologie, Johannes-Gutenberg-Universität Mainz.
Schneider
T
T
Dick
W
W
Elich
D
D
Mauer
M
M
D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004632:Emergency Medical Services; D005260:Female; D005858:Germany; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010348:Patient Care Team; D011446:Prospective Studies; D015996:Survival Rate