Effect of active compression-decompression resuscitation (ACD-CPR) on survival: A combined analysis using individual patient data

Dietmar K. Mauer, Jerry Nolan, Patrick Plaisance, Helmut Sitter, Henry Benoit, Ian G. Stiell, Euthymios Sofianos, Niels Keiding, Keith G Lurie

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

Active compression decompression resuscitation (ACD-CPR) has been developed as an alternative to standard cardiopulmonary resuscitation (S-CPR). To determine the effect of ACD-CPR on survival and neurologic outcome in patients with out-of-hospital cardiac arrest, this combined analysis involved individual patient data from 2866 patients from seven separate randomized prospective prehospital studies who had received ACD-CPR or S-CPR after out-of-hospital cardiac arrest in seven international sites. Significant improvement in 1-h survival (odds ratio (OR) = 0.83; confidence interval (CI): 0.695-0.99; P < 0.05) was found with ACD-CPR (n = 1410) versus S-CPR (n = 1456). The odds ratio for hospital discharge after ACD-CPR was similar (OR = 0.82; CI: 0.609-1.107, P = NS), but this finding was not statistically significant. Using the χ2-test for trend, there was a significant improvement in overall survival with ACD-CPR (P < 0.05) versus S-CPR. This improvement was largely due to the influence of results from one study site. Neurological outcome and complication rates were comparable between groups. Further study is needed to determine which emergency medical services systems may benefit from out-of-hospital use of ACD-CPR.

Original languageEnglish (US)
Pages (from-to)249-256
Number of pages8
JournalResuscitation
Volume41
Issue number3
DOIs
StatePublished - Aug 1 1999

Keywords

  • Advanced cardiac life support
  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Compression
  • Decompression
  • Emergency medical service
  • Survival

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    Mauer, D. K., Nolan, J., Plaisance, P., Sitter, H., Benoit, H., Stiell, I. G., Sofianos, E., Keiding, N., & Lurie, K. G. (1999). Effect of active compression-decompression resuscitation (ACD-CPR) on survival: A combined analysis using individual patient data. Resuscitation, 41(3), 249-256. https://doi.org/10.1016/S0300-9572(99)00073-8