title: Automated cardiopulmonary resuscitation using a load-distributing band external cardiac support device for in-hospital cardiac arrest: a single centre experience of AutoPulse-CPR.
abstract: BACKGROUND
  Poor quality cardiopulmonary resuscitation (CPR) predicts adverse outcome. During invasive cardiac procedures automated-CPR (A-CPR) may help maintain effective resuscitation. The use of A-CPR following in-hospital cardiac arrest (IHCA) remains poorly described.
  
  
  OBJECTIVE
  Firstly, we aimed to assess the efficiency of healthcare staff using A-CPR in a cardiac arrest scenario at baseline, following re-training and over time (Scenario-based training). Secondly, we studied our clinical experience of A-CPR at our institution over a 2-year period, with particular emphasis on the details of invasive cardiac procedures performed, problems encountered, resuscitation rates and in-hospital outcome (AutoPulse-CPR Registry).
  
  
  RESULTS
  Scenario-based training: Forty healthcare professionals were assessed. At baseline, time-to-position device was slow (mean 59 (±24) s (range 15-96s)), with the majority (57%) unable to mode-switch. Following re-training time-to-position reduced (28 (±9) s, p<0.01 vs baseline) with 95% able to mode-switch. This improvement was maintained over time. AutoPulse-CPR Registry: 285 patients suffered IHCA, 25 received A-CPR. Survival to hospital discharge following conventional CPR was 28/260 (11%) and 7/25 (28%) following A-CPR. A-CPR supported invasive procedures in 9 patients, 2 of whom had A-CPR dependant circulation during transfer to the catheter lab.
  
  
  CONCLUSIONS
  A-CPR may provide excellent haemodynamic support and facilitate simultaneous invasive cardiac procedures. A significant learning curve exists when integrating A-CPR into clinical practice. Further studies are required to better define the role and effectiveness of A-CPR following IHCA.
authors.affiliation: The Queen Elizabeth Hospital, University Hospitals Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. Electronic address: jspiro@doctors.org.uk.
authors.forename: J R
authors.initials: JR
authors.lastname: Spiro
authors.affiliation: The Queen Elizabeth Hospital, University Hospitals Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
authors.forename: S
authors.initials: S
authors.lastname: White
authors.affiliation: The Queen Elizabeth Hospital, University Hospitals Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
authors.forename: N
authors.initials: N
authors.lastname: Quinn
authors.affiliation: The Queen Elizabeth Hospital, University Hospitals Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: Gubran
authors.affiliation: The Queen Elizabeth Hospital, University Hospitals Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
authors.forename: P F
authors.initials: PF
authors.lastname: Ludman
authors.affiliation: The Queen Elizabeth Hospital, University Hospitals Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
authors.forename: J N
authors.initials: JN
authors.lastname: Townend
authors.affiliation: The Queen Elizabeth Hospital, University Hospitals Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
authors.forename: S N
authors.initials: SN
authors.lastname: Doshi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001331:Automation / Q000295:instrumentation*; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D004632:Emergency Medical Services / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Automated cardiopulmonary resuscitation; Emergency percutaneous coronary intervention; In-hospital cardiac arrest