Faculty Collaboration Database

Treatment of non-traumatic out-of-hospital cardiac arrest with active compression decompression cardiopulmonary resuscitation plus an impedance threshold device. Resuscitation 2013 Sep;84(9):1214-22

Date

05/15/2013

Pubmed ID

23669489

Pubmed Central ID

PMC3752326

DOI

10.1016/j.resuscitation.2013.05.002

Scopus ID

2-s2.0-84882875250 (requires institutional sign-in at Scopus site)   46 Citations

Abstract

BACKGROUND: A recent out-of-hospital cardiac arrest (OHCA) clinical trial showed improved survival to hospital discharge (HD) with favorable neurologic function for patients with cardiac arrest of cardiac origin treated with active compression decompression cardiopulmonary resuscitation (CPR) plus an impedance threshold device (ACD+ICD) versus standard (S) CPR. The current analysis examined whether treatment with ACD+ITD is more effective than standard (S-CPR) for all cardiac arrests of non-traumatic origin, regardless of the etiology.

METHODS: This is a secondary analysis of data from a randomized, prospective, multicenter, intention-to-treat, OHCA clinical trial. Adults with presumed non-traumatic cardiac arrest were enrolled and followed for one year post arrest. The primary endpoint was survival to hospital discharge (HD) with favorable neurologic function (Modified Rankin Scale score ≤ 3).

RESULTS: Between October 2005 and July 2009, 2738 patients were enrolled (S-CPR=1335; ACD+ITD=1403). Survival to HD with favorable neurologic function was greater with ACD+ITD compared with S-CPR: 7.9% versus 5.7%, (OR 1.42, 95% CI 1.04, 1.95, p=0.027). One-year survival was also greater: 7.9% versus 5.7%, (OR 1.43, 95% CI 1.04, 1.96, p=0.026). Nearly all survivors in both groups had returned to their baseline neurological function by one year. Major adverse event rates were similar between groups.

CONCLUSIONS: Treatment of out-of-hospital non-traumatic cardiac arrest patients with ACD+ITD resulted in a significant increase in survival to hospital discharge with favorable neurological function when compared with S-CPR. A significant increase survival rates was observed up to one year after arrest in subjects treated with ACD+ITD, regardless of the etiology of the cardiac arrest.

Author List

Frascone RJ, Wayne MA, Swor RA, Mahoney BD, Domeier RM, Olinger ML, Tupper DE, Setum CM, Burkhart N, Klann L, Salzman JG, Wewerka SS, Yannopoulos D, Lurie KG, O'Neil BJ, Holcomb RG, Aufderheide TP

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Cardiography, Impedance
Cardiopulmonary Resuscitation
Combined Modality Therapy
Confidence Intervals
Evaluation Studies as Topic
Female
Heart Massage
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Odds Ratio
Out-of-Hospital Cardiac Arrest
Patient Discharge
Prospective Studies
Reference Values
Risk Assessment
Survival Rate
Treatment Outcome
Wounds and Injuries
Young Adult