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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
PubMed
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.

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Active chest compression-decompression for cardiopulmonary resuscitation.

The Cochrane database of systematic reviews·2004

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.

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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.