Survival From In-Hospital Cardiac Arrest With Interposed Abdominal Counterpulsation During Cardiopulmonary Resuscitation

Abstract

--We conclude that the addition of IAC to standard CPR may improve meaningful survival following in-hospital cardiac arrest. The optimal use of this technique awaits further clinical trials.

Haemodynamic effect of intermittent abdominal compression during cardiopulmonary resuscitation in the critically ill

“…2,24 Our study demonstrates that manual IAC-CPR is feasible in critically ill patients may be associated with return of spontaneous circulation in a substantial number of patients, in line with studies suggesting increased survival from in-hospital cardiac arrest. 20,21 The low long-term survival rate of our critically ill patients agrees with the poor survival, reported in the literature, of PEA and brady-asystole and of CPR during critical illness. 25 Many modifications of standard CPR utilize additional equipment and are therefore impractical.…”

“…2,4,6 Á 9,11,13,23,24 However, the effect of IAC-CPR on arterial blood pressure contours in man is either poorly documented Á/ in the absence of arterial catheters for pressure monitoring in most of the patients undergoing CPR, even in the hospital Á/ or is controversial with variable responses of aortic and coronary perfusion pressure. 2,10,12,15 Á 19 To document the beneficial effect of IAC-CPR on arterial blood pressure contours in man and to explain the improved outcome over standard CPR in the hospital, 20,21 we studied the pressure effects of IAC-CPR in 12 critically ill, haemodynamically monitored patients.…”

Part 7: CPR Techniques and Devices

“…In 2 randomized in-hospital trials, IAC-CPR performed by trained rescuers improved short-term survival 17 and survival to hospital discharge 18 compared with conventional CPR for adult cardiac arrest. The data from these studies were combined in 2 positive meta-analyses.…”

Guideline for resuscitation in cardiac arrest after cardiac surgery

“…There have been three RCTs [116][117][118] that showed an improvement in outcome measures of IAC-CPR. Trials involving CPR are often small but a meta-analysis of IAC-CPR [119] limited to human clinical trials comparing IAC-CPR to standard CPR showed a statistically significant benefit in favour of the IAC-CPR in return of spontaneous circulation.…”