Introduction This study was designed to compare the outcomes of standard cardiopulmonary resuscitation (STD-CPR) and combined chest compression and abdominal compression–decompression cardiopulmonary resuscitation (CO-CPR) with a new device following out-of-hospital cardiac arrest (OHCA). Moreover, we investigated whether patient prognosis improved with this combination treatment. Methods This trial was a single-centre, prospective, randomized trial, and a blinded assessment of the outcomes was performed. A total of 297 consecutive patients with OHCA were initially screened, and 278 were randomized to the STD-CPR group (n = 135) or the CO-CPR group (n = 143). We compared the proportions of patients who achieved a return of spontaneous circulation (ROSC), survived to hospital admission and survived to hospital discharge. In addition, we also performed the Kaplan–Meier analysis with a log-rank test at the end of the follow-up period to compare the survival curves of the two groups. Results The differences were not statistically significant in the proportion of patients who achieved ROSC [31/135 (23.0%) versus 35/143 (24.5%)] and survived to hospital admission [28/135 (20.7%) versus 33/143 (23.1%)] between the CO-CPR group and STD-CPR group. However, there was a significant difference in the proportion of patients who survived to hospital discharge [16/135 (11.9%) versus 7/143 (4.9%)] between the two groups. Nine patients (6.7%) in the CO-CPR group and 2 patients (1.4%) in the STD group showed good neurological outcomes according to the cerebral performance category (CPC) scale score, and the difference was statistically significant (P = 0.003). The Kaplan–Meier curves showed that the patients in the CO-CPR group achieved better survival benefits than those in the STD-CPR group at the end of the follow-up period (log-rank P = 0.007). Conclusion CO-CPR was more beneficial than STD-CPR in terms of survival benefits in patients who have suffered out-of-hospital cardiac arrest. Trial registration Chinese Clinical Trial Registry, registered number: ChiCTR2100049581. Registered 30 July 2021- Retrospectively registered. http://www.medresman.org.cn/uc/index.aspx.

Introduction: This study was designed to compare outcomes between standard cardiopulmonary resuscitation (STD-CPR) and combined chest compression and abdominal compression-decompression cardiopulmonary resuscitation (CO-CPR) with a new device following out-of-hospital cardiac arrest. Moreover, we investigated whether patient prognosis improved with this combination treatment.Methods: This trial was a single-center, prospective, randomized trial with a blinded assessment of the outcome. A total of 297 consecutive patients with OHCA were initially screened, and 278 were randomized to STD-CPR (n=135) or CO-CPR (n=143). We compared return of spontaneous circulation (ROSC) rates, survival to hospital admission rates, survival to hospital discharge rates, and neurological outcomes at hospital discharge between the two groups. In addition, we also performed the Kaplan-Meier analysis at the end of the follow-up. Results: An ROSC rate of 31/135 (22.96%) versus 35/143 (24.48%), and survival to a hospital admission rate of 28/135 (20.74%) versus 33/143 (23.07%) were found between in the CO-CPR group and the STD-CPR group respectively. The difference did not reach statistical significance. However, there was a significant difference in the survival to hospital discharge rates of 16/135 (11.85%) versus 7/143 (4.90%) between the two groups. 9 patients (6.67%) in the CO-CPR group versus 2 patients (1.40%) in the STD group with good neurological outcomes were obtained according to the CPC status, and the difference was statistically significant( P=0.003). And the Kaplan-Meier analysis showed a survival benefit favoring the CO-CPR group over the STD-CPR group at the end of the follow-up (P=0.007).Conclusion: Patients who had suffered out-of-hospital cardiac arrest could achieve better survival benefits from CO-CPR than from STD-CPR.