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. 2012 Aug 3;16(4):R144.
doi: 10.1186/cc11456.

Improved neurologically intact survival with the use of an automated, load-distributing band chest compression device for cardiac arrest presenting to the emergency department

Marcus Eng Hock Ong, Stephanie Fook-Chong, Annitha Annathurai, Shiang Hu Ang, Ling Tiah, Kok Leong Yong, Zhi Xiong Koh, Susan Yap, Papia Sultana

Improved neurologically intact survival with the use of an automated, load-distributing band chest compression device for cardiac arrest presenting to the emergency department

Marcus Eng Hock Ong et al. Crit Care. .

Abstract

Introduction: It has been unclear if mechanical cardiopulmonary resuscitation (CPR) is a viable alternative to manual CPR. We aimed to compare resuscitation outcomes before and after switching from manual CPR to load-distributing band (LDB) CPR in a multi-center emergency department (ED) trial.

Methods: We conducted a phased, prospective cohort evaluation with intention-to-treat analysis of adults with non-traumatic cardiac arrest. At these two urban EDs, systems were changed from manual CPR to LDB-CPR. Primary outcome was survival to hospital discharge, with secondary outcome measures of return of spontaneous circulation, survival to hospital admission and neurological outcome at discharge.

Results: A total of 1,011 patients were included in the study, with 459 in the manual CPR phase (January 01, 2004, to August 24, 2007) and 552 patients in the LDB-CPR phase (August 16, 2007, to December 31, 2009). In the LDB phase, the LDB device was applied in 454 patients (82.3%). Patients in the manual CPR and LDB-CPR phases were comparable for mean age, gender and ethnicity. The mean duration from collapse to arrival at ED (min) for manual CPR and LDB-CPR phases was 34:03 (SD16:59) and 33:18 (SD14:57) respectively. The rate of survival to hospital discharge tended to be higher in the LDB-CPR phase (LDB 3.3% vs Manual 1.3%; adjusted OR, 1.42; 95% CI, 0.47, 4.29). There were more survivors in LDB group with cerebral performance category 1 (good) (Manual 1 vs LDB 12, P = 0.01). Overall performance category 1 (good) was Manual 1 vs LDB 10, P = 0.06.

Conclusions: A resuscitation strategy using LDB-CPR in an ED environment was associated with improved neurologically intact survival on discharge in adults with prolonged, non-traumatic cardiac arrest.

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Figures

Figure 1
Figure 1
Utstein reporting template for data elements. LBD, load-distributing band; CPR, cardiopulmonary resuscitation; ROSC, return of spontaneous circulation.
Figure 2
Figure 2
Return of spontaneous circulation by phases. LBD, load-distributing band; CPR, cardiopulmonary resuscitation; ROSC, return of spontaneous circulation.
Figure 3
Figure 3
Survival to discharge by phases. LBD, load-distributing band; CPR, cardiopulmonary resuscitation.
See this image and copyright information in PMC

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