Interposed abdominal compression CPR versus standard CPR in prehospital cardiopulmonary arrest: preliminary results

Recent studies evaluating interposed abdominal compression cardiopulmonary resuscitation (IAC-CPR) have demonstrated a significant increase in cardiac output, mean arterial pressure, and cerebral perfusion compared with standard CPR. A clinical evaluation of IAC-CPR effectiveness on resuscitation outcome has not been reported. A prospective, randomized study comparing IAC-CPR with standard CPR for resuscitation of prehospital cardiopulmonary arrest was developed utilizing the Milwaukee County Paramedic System. When the paramedics arrive, standard CPR is initiated or continued, and countershocks are delivered when appropriate. The patients are randomized into IAC-CPR and standard CPR groups immediately following endotracheal intubation. Abdominal compression force is standardized to 100 mm Hg +/- 20 mm Hg by using a simple airfilled bladder and gauge to monitor each compression. Resuscitations are conducted according to standard advanced cardiac life support guidelines through continuous radio-telemetry contact with a base physician. Since October 1983, 140 patients have qualified for the study group. Seventy patients had standard CPR and 30% (21/70) were admitted to the emergency department with a rhythm and pulse, as were 34% (24/70) of the patients treated with IAC-CPR. The difference between study groups was not significant. To determine if abdominal compression increases regurgitation, the frequency of emesis before and after intubation was analyzed. No significant difference was found between the IAC-CPR and standard CPR groups.(ABSTRACT TRUNCATED AT 250 WORDS)