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Active chest compression-decompression for cardiopulmonary resuscitation.

C Lafuente-Lafuente1, M Melero-Bascones

  • 1Area de Urgencias / Unidad de Documentación, Clínica Moncloa, Avda. Valladolid, 83, Madrid, Spain. carmelolafuente@jazzfree.com

The Cochrane Database of Systematic Reviews
|July 26, 2002
PubMed
Summary

Active compression-decompression cardiopulmonary resuscitation (ACDR CPR) showed no clear survival benefit compared to standard CPR. While not increasing mortality, ACDR CPR was associated with more frequent skin trauma and a trend towards severe neurological damage.

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Active chest compression-decompression for cardiopulmonary resuscitation.

The Cochrane database of systematic reviews·2004

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Resuscitation Science

Background:

  • Active compression-decompression cardiopulmonary resuscitation (ACDR CPR) utilizes a suction device for chest compression and active decompression.
  • Existing randomized controlled trials on ACDR CPR have yielded conflicting results.

Purpose of the Study:

  • To compare the clinical effects and safety of ACDR CPR against standard manual cardiopulmonary resuscitation (STR).

Main Methods:

  • Systematic review of randomized and quasi-randomized trials comparing ACDR CPR with STR in adult cardiac arrest patients.
  • Searches included Cochrane Controlled Trials Register, MEDLINE, and EMBASE, supplemented by reference checking and manufacturer contact.
  • Data analysis included intention-to-treat principles, pooled relative risk estimation, and predefined subgroup analyses by setting and team composition.

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Main Results:

  • Twelve trials (4162 patients in out-of-hospital settings) found no significant difference in mortality between ACDR CPR and STR.
  • A non-significant trend towards more frequent severe neurological damage was observed with ACDR CPR (RR 3.11 [95% CI 0.98 - 9.83]).
  • Complication rates for fractures and pneumothorax were similar, but skin trauma and ecchymosis were more frequent with ACDR CPR.

Conclusions:

  • Active chest compression-decompression cardiopulmonary resuscitation does not demonstrate a clear clinical benefit in patients experiencing cardiac arrest.
  • Further research is needed to fully assess neurological outcomes and potential harms associated with ACDR CPR.