Active decompression improves the haemodynamic state during cardiopulmonary resuscitation

Abstract

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 nontraumatic, normothermic, out of hospital cardiac arrest. Interventions: Cardiopulmonary resuscitation was performed during resuscitation in alternating 5 min cycles of conventional and active compression-decompression cardiopulmonary resuscitation. Main outcome measures: The end tidal carbon dioxide (ET(CO2)), 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: ET(CO2), was monitored in 36 patients during conventional and active compression-decompression cardiopulmonary resuscitation. Active compression-decompression cardiopulmonary resuscitation caused a significant increase in ET(CO2) (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.