Mechanical cardiopulmonary resuscitation for patients with cardiac arrest

Jiang, Lijia; Zhang, Jinsong

doi:10.5847/wjem.j.1920-8642.2011.03.001

Cited by 24 publications

(24 citation statements)

References 33 publications

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“…Chest compressions only generate 25% to 30% of the normal cardiac output when they are performed under optimal conditions. [ 35 ] Therefore, the prolonged CPR is related to a low likelihood of ROSC and increased cerebral damage. [ 36 ] Hence, pre-hospital ROSC could contribute to survival to hospital discharge and good neurological outcomes.…”

Section: Discussionmentioning

confidence: 99%

Outcome analysis of traumatic out-of-hospital cardiac arrest patients according to the mechanism of injury

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Outcome analysis of traumatic out-of-hospital cardiac arrest patients according to the mechanism of injury

et al. 2020

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“…The reported success rate of CPR ranged from 5% to 10%. [3] The reported coronary World J Emerg Med, Vol 4, No 4, 2013 perfusion pressure (CPP), which was closely related to the successful resuscitation, was far from normal in patients with CA receiving S-CRP. [4] Active compressiondecompression cardiopulmonary resuscitation (ACD-CPR) with a hand-held suction device is applied on the mid sternum to compress the chest and then to actively decompress the chest after each compression.…”

Section: Introductionmentioning

confidence: 99%

Active compression-decompression cardiopulmonary resuscitation (CPR) versus standard CPR for cardiac arrest patients: a meta-analysis

Luo

Zhang

Chen

et al. 2013

World Journal of Emergency Medicine

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BACKGROUND: Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) has been popular in the treatment of patients with cardiac arrest (CA). However, the effect of ACD-CPR versus conventional standard CPR (S-CRP) is contriversial. This study was to analyze the effi cacy and safety of ACD-CPR versus S-CRP in treating CA patients. METHODS:Randomized or quasi-randomized controlled trials published from January 1990 to March 2011 were searched with the phrase "active compression-decompression cardiopulmonary resuscitation and cardiac arrest" in PubMed, EmBASE, and China Biomedical Document Databases. The Cochrane Library was searched for papers of meta-analysis. Restoration of spontaneous circulation (ROSC) rate, survival rate to hospital admission, survival rate at 24 hours, and survival rate to hospital discharge were considered primary outcomes, and complications after CPR were viewed as secondary outcomes. Included studies were critically appraised and estimates of effects were calculated according to the model of fi xed or random effects. Inconsistency across the studies was evaluated using the I 2 statistic method. Sensitivity analysis was made to determine statistical heterogeneity. RESULTS:Thirteen studies met the criteria for this meta-analysis. The studies included 396 adult CA patients treated by ACD-CPR and 391 patients by S-CRP. Totally 234 CA patients were found out hospitals, while the other 333 CA patients were in hospitals. Two studies were evaluated with high-quality methodology and the rest 11 studies were of poor quality. ROSC rate, survival rate at 24 hours and survival rate to hospital discharge with favorable neurological function indicated that ACD-CPR is superior to S-CRP, with relative risk (RR) values of 1.39 (95% CI 0.99-1.97), 1.94 (95% CI 1.45-2.59) and 2.80 (95% CI 1. 60-5.24). No significant differences were found in survival rate to hospital admission and survival rate to hospital discharge for ACD-CPR versus S-CRP with RR values of 1.06 (95% CI 0.76-1.60) and 1.00 (95% CI 0.73-1.38).CONCLUSION: Quality controlled studies confirmed the superiority of ACD-CPR to S-CRP in terms of ROSC rate and survival rate at 24 hours. Compared with S-CRP, ACD-CPR could not improve survival rate to hospital admission or survival rate to hospital discharge.

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“…Despite decades of research, improved access to automated external defibrillators, refinement of cardiac life support algorithms, and implementation of therapeutic hypothermia, only 5.5-10.4% of patients who suffer out of hospital cardiac arrest survive to hospital discharge [2,3]. Cardiopulmonary resuscitation (CPR) is inherently inefficient and generates only 20-30% of baseline cardiac output despite proper technique [4]. Resuscitative endovascular balloon occlusion of the aorta (REBOA), an approach currently used in trauma patients to control noncompressible truncal hemorrhage, may be a novel intervention to improve CPR quality [5,6].…”

Section: Introductionmentioning

confidence: 99%

Zone 3 REBOA does not provide hemodynamic benefits during nontraumatic cardiac arrest

Nowadly

Hoareau

Grayson

et al. 2020

The American Journal of Emergency Medicine

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Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) may be a novel intervention to improve cardiopulmonary resuscitation (CPR) quality during cardiac arrest. Zone 1 supraceliac aortic occlusion improves coronary and cerebral blood flow. It is unknown if Zone 3 occlusion distal to the renal arteries offers a similar physiologic benefit while maintaining blood flow to organs above the point of occlusion. Methods: Fifteen swine were anesthetized, instrumented, and placed into ventricular fibrillation. Mechanical CPR was immediately initiated. After 5 min of CPR, Zone 1 REBOA, Zone 3 REBOA, or no intervention (control) was initiated. Hemodynamic variables were continuously recorded for 30 min. Results: There were no significant differences between groups before REBOA deployment. Once REBOA was deployed, Zone 1 animals had statistically greater diastolic blood pressure compared to control (median [IQR]: 19.9 mmHg [9.5-20.5] vs 3.9 mmHg [2.4-4.8], p = .006). There were no differences in diastolic blood pressure between Zone 1 and Zone 3 (8.6 mmHg [5.1-13.1], p = .10) or between Zone 3 and control (p = .10). There were no significant differences in systolic blood pressure, cerebral blood flow, or time to return of spontaneous circulation (ROSC) between groups. Conclusion: In our swine model of cardiac arrest, Zone 1 REBOA improved diastolic blood pressure when compared to control. Zone 3 does not offer a hemodynamic benefit when compared to no occlusion. Unlike prior studies, immediate use of REBOA after arrest did not result in an increase in ROSC rate, suggesting REBOA may be more beneficial in patients with prolonged no-flow time.

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Mechanical cardiopulmonary resuscitation for patients with cardiac arrest

Cited by 24 publications

References 33 publications

Outcome analysis of traumatic out-of-hospital cardiac arrest patients according to the mechanism of injury

Outcome analysis of traumatic out-of-hospital cardiac arrest patients according to the mechanism of injury

Active compression-decompression cardiopulmonary resuscitation (CPR) versus standard CPR for cardiac arrest patients: a meta-analysis

Zone 3 REBOA does not provide hemodynamic benefits during nontraumatic cardiac arrest

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