TY - JOUR
T1 - The impact of a new CPR assist device on rate of return of spontaneous circulation in out-of-hospital cardiac arrest
AU - Casner, Michael
AU - Andersen, David
AU - Isaacs, S. Marshal
PY - 2005/1
Y1 - 2005/1
N2 - Objective. The San Francisco Fire Department deployed an automated, load-distributing-band chest compression device (AutoPulse, Revivant Corporation) to evaluate its function in a large urban emergency medical services (EMS) service. A retrospective chart review was undertaken to determine whether the AutoPulse had altered short-term patient outcome, specifically, return of spontaneous circulation (ROSC). Methods. AutoPulse cardiopulmonary resuscitation (A-CPR) was used by paramedic captains responding to adult cardiac arrests with an average ±SD response time of 15 ± 5 minutes. The primary endpoint was patient arrival to an emergency department with measurable spontaneous pulses. The manual CPR comparison group was case-matched for age, gender, initial presenting electrocardiogram rhythm, and the number of doses of Advanced Cardiac Life Support medications as a proxy for treatment time. Matching was performed by an investigator blinded to outcome and treatment group. Results. Sixty-nine AutoPulse uses were matched to 93 manual-CPR-only cases. A-CPR showed improvement in the primary outcome when compared with manual CPR with any presenting rhythm (A-CPR 39%, manual 29%, p = 0.003). When patients were classified by first presenting rhythm, shockable rhythms showed no difference in outcome (A-CPR 44%, manual 50%, p = 0.340). Outcome was improved with A-CPR in initial presenting asystole and approached significance with pulse-less electrical activity (PEA)(asystole: A-CPR 37%, manual 22%, p = 0.008; PEA: A-CPR 38%, manual 23%, p = 0.079). Conclusion. The AutoPulse may improve the overall likelihood of sustained ROSC and may particularly benefit patients with nonshockable rhythms. A prospective randomized trial comparing the Auto Pulse with manual CPR in the setting of out-of-hospital sudden cardiac arrest is under way.
AB - Objective. The San Francisco Fire Department deployed an automated, load-distributing-band chest compression device (AutoPulse, Revivant Corporation) to evaluate its function in a large urban emergency medical services (EMS) service. A retrospective chart review was undertaken to determine whether the AutoPulse had altered short-term patient outcome, specifically, return of spontaneous circulation (ROSC). Methods. AutoPulse cardiopulmonary resuscitation (A-CPR) was used by paramedic captains responding to adult cardiac arrests with an average ±SD response time of 15 ± 5 minutes. The primary endpoint was patient arrival to an emergency department with measurable spontaneous pulses. The manual CPR comparison group was case-matched for age, gender, initial presenting electrocardiogram rhythm, and the number of doses of Advanced Cardiac Life Support medications as a proxy for treatment time. Matching was performed by an investigator blinded to outcome and treatment group. Results. Sixty-nine AutoPulse uses were matched to 93 manual-CPR-only cases. A-CPR showed improvement in the primary outcome when compared with manual CPR with any presenting rhythm (A-CPR 39%, manual 29%, p = 0.003). When patients were classified by first presenting rhythm, shockable rhythms showed no difference in outcome (A-CPR 44%, manual 50%, p = 0.340). Outcome was improved with A-CPR in initial presenting asystole and approached significance with pulse-less electrical activity (PEA)(asystole: A-CPR 37%, manual 22%, p = 0.008; PEA: A-CPR 38%, manual 23%, p = 0.079). Conclusion. The AutoPulse may improve the overall likelihood of sustained ROSC and may particularly benefit patients with nonshockable rhythms. A prospective randomized trial comparing the Auto Pulse with manual CPR in the setting of out-of-hospital sudden cardiac arrest is under way.
KW - Automated CPR
KW - Cardiac arrest
KW - Cardiopulmonary resuscitation
KW - Chest compressions
KW - Survival
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U2 - 10.1080/10903120590891714
DO - 10.1080/10903120590891714
M3 - Review article
C2 - 16036830
AN - SCOPUS:23244435765
SN - 1090-3127
VL - 9
SP - 61
EP - 67
JO - Prehospital Emergency Care
JF - Prehospital Emergency Care
IS - 1
ER -