A Review of CPR Augmentation Devices

Area of Science:

• Emergency Medicine
• Cardiology
• Resuscitation Science

Background:

• Cardiac arrest management relies on effective cardiopulmonary resuscitation (CPR).
• CPR augmentation devices aim to improve resuscitation outcomes.
• The ZOLL ResQCPR system, including ResQPUMP (ACD) and ResQPOD (ITD), are key devices.

Purpose of the Study:

• To assess the effectiveness of CPR augmentation devices on patient outcomes.
• To evaluate manual active compression-decompression (ACD) devices and impedance threshold devices (ITDs).

Main Methods:

• A literature review of studies published between January 2015 and March 2023.
• Inclusion of recent, PubMed-indexed, or highly cited articles.
• Exclusion of studies with potential author bias (employed by ZOLL).

Main Results:

• ACD devices increased chest compliance by 30%-50% in human cadavers (p<0.05).
• ACD improved return of spontaneous circulation (ROSC) and neurological outcomes by 50% in a human trial (n=1,653; p<0.02).
• ResQPOD (ITD) effectiveness showed mixed results, with one large trial finding no significant difference (n=8,718; p=0.71), but post hoc analysis suggested significance with CPR quality adjustments.

Conclusions:

• Manual ACD devices are a valuable alternative to standard CPR for improving survival with good neurological function.
• ACD devices should be implemented in prehospital and hospital emergency settings.
• ITDs show promise but require further research due to controversial findings.