Active decompression improves the haemodynamic state during cardiopulmonary resuscitation

• Published in: British Heart Journal Vol. 73; no. 4; pp. 372 - 376
• Main Authors: Guly, U. M., Robertson, C. E.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01-04-1995; BMJ; BMJ Publishing Group LTD
• Subjects: Acid-Base Equilibrium; Adult; Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Pressure; Cardiac Output; Cardiopulmonary Resuscitation - methods; Cross-Over Studies; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Female; Heart Arrest - therapy; Hemodynamics; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; Prospective Studies; Human; Intensive cardiocirculatory care; Cardiocirculatory arrest; Treatment; Cardiovascular disease; Exploration; Apparatus; Hemodynamics; Cardiac massage
• ISSN: 0007-0769; 1468-201X; 2053-5864
• DOI: 10.1136/hrt.73.4.372

OBJECTIVE--To examine whether use of the active compression-decompression device improves the haemodynamics of cardiopulmonary resuscitation compared with those of conventional cardiopulmonary resuscitation. DESIGN--Prospective crossover study. SETTING--The accident and emergency department of a university teaching hospital. PATIENTS--36 adult patients with non-traumatic, normothermic, out of hospital cardiac arrest. INTERVENTIONS--Cardiopulmonary resuscitation was performed during resuscitation in alternating 3 min cycles of conventional and active compression-decompression cardiopulmonary resuscitation. MAIN OUTCOME MEASURES--The end tidal carbon dioxide (ETCO2), femoral arterial pressure, and acid-base analysis of central venous blood measured during the last 30 s of each 3 minute cardiopulmonary resuscitation cycle. RESULTS--ETCO2 was monitored in 36 patients during conventional and active compression-decompression cardiopulmonary resuscitation. Active compression-decompression cardiopulmonary resuscitation caused a significant increase in ETCO2 (P < 0.0002), indicating improved cardiac output. Arterial pressure measurement was carried out in 10 patients. Systolic pressure was significantly greater with active compression-decompression than conventional cardiopulmonary resuscitation (P < 0.007). Central venous blood was taken for acid-base analysis in 11 patients. There was a significant increase in the central venous hydrogen ion concentration (P = 0.025) with rises in the partial pressures of carbon dioxide and oxygen, suggesting improved venous return. CONCLUSIONS--This study confirms that active compression-decompression cardiopulmonary resuscitation is associated with better haemodynamic status than conventional resuscitation.