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Active chest compression-decompression for cardiopulmonary resuscitation
C Lafuente-Lafuente1, M Melero-Bascones
1Area de Urgencias, Clínica Moncloa, Avda. Valladolid, 83, Madrid, Spsin, 28008. carmelolafuente@jazzfree.com
The Cochrane Database of Systematic Reviews
|November 1, 2001
Summary
Active chest compression-decompression cardiopulmonary resuscitation (ACD CPR) showed no clear benefits compared to standard CPR. While mortality rates were similar, ACD CPR had more skin trauma and a trend towards severe neurological damage in survivors.
Area of Science:
- Cardiology
- Emergency Medicine
- Critical Care
Background:
- Active compression-decompression cardiopulmonary resuscitation (ACD CPR) utilizes a device for chest compression and active decompression.
- Existing randomized controlled trials on ACD CPR have yielded conflicting results regarding its efficacy.
Purpose of the Study:
- To evaluate the clinical effects and safety of ACD CPR in comparison to standard manual cardiopulmonary resuscitation (STR).
Main Methods:
- A comprehensive literature search was conducted across multiple databases (Cochrane Heart Group, MEDLINE, EMBASE) and manufacturer contact.
- Included were randomized and quasi-randomized studies comparing ACD CPR with STR in adult cardiac arrest patients treated by medical or paramedical teams.
- Data extraction was independent, analysis was intention-to-treat, and pooled relative risk was estimated with predefined subgroup analyses.
Main Results:
- Twelve trials (10 out-of-hospital) involving over 4000 patients were analyzed.
- No significant differences were found in mortality (immediate or at discharge) between ACD CPR and STR.
- A non-significant trend towards more frequent severe neurological damage and increased skin trauma was observed with ACD CPR.
Conclusions:
- Active chest compression-decompression cardiopulmonary resuscitation (ACD CPR) does not demonstrate clear clinical benefits over standard CPR.
- The safety profile of ACD CPR shows an increased incidence of skin trauma without significant differences in major complications like fractures or pneumothorax.