TY - JOUR
T1 - A comparison of standard cardiopulmonary resuscitation and active compression-decompression resuscitation for out-of-hospital cardiac arrest
AU - Plaisance, Patrick
AU - Lurie, Keith G.
AU - Vicaut, Eric
AU - Adnet, Frederic
AU - Petit, Jean Luc
AU - Epain, Daniel
AU - Ecollan, Patrick
AU - Gruat, Renaud
AU - Cavagna, Patrice
AU - Biens, Jean
AU - Payen, Didier
PY - 1999/8/19
Y1 - 1999/8/19
N2 - Background: We previously observed that short-term survival after out- of-hospital cardiac arrest was greater with active compression-decompression cardiopulmonary resuscitation (CPR) than with standard CPR. In the current study, we assessed the effects of the active compression-decompression method on one-year survival. Methods: Patients who had cardiac arrest in the Paris metropolitan area or in Thionville, France, more than 80 percent of whom had asystole, were assigned to receive either standard CPR (377 patients) or active compression-decompression CPR (373 patients) according to whether their arrest occurred on an even or odd day of the month, respectively. The primary end point was survival at one year. The rate of survival to hospital discharge without neurologic impairment and the neurologic outcome were secondary end points. Results: Both the rate of hospital discharge without neurologic impairment (6 percent vs. 2 percent, P = 0.01) and the one-year survival rate (5 percent vs. 2 percent, P = 0.03) were significantly higher among patients who received active compression-decompression CPR than among those who received standard CPR. All patients who survived to one year had cardiac arrests that were witnessed. Nine of 17 one-year survivors in the active compression-decompression group and 2 of 7 in the standard group, respectively, initially had asystole or pulseless electrical activity. In 12 of the 17 survivors who had received active compression-decompression CPR, neurologic status returned to base line, as compared with 3 of 7 survivors who had received standard CPR (P = 0.34). Conclusions: Active compression- decompression CPR performed during advanced life support significantly improved long-term survival rates among patients who had cardiac arrest outside the hospital.
AB - Background: We previously observed that short-term survival after out- of-hospital cardiac arrest was greater with active compression-decompression cardiopulmonary resuscitation (CPR) than with standard CPR. In the current study, we assessed the effects of the active compression-decompression method on one-year survival. Methods: Patients who had cardiac arrest in the Paris metropolitan area or in Thionville, France, more than 80 percent of whom had asystole, were assigned to receive either standard CPR (377 patients) or active compression-decompression CPR (373 patients) according to whether their arrest occurred on an even or odd day of the month, respectively. The primary end point was survival at one year. The rate of survival to hospital discharge without neurologic impairment and the neurologic outcome were secondary end points. Results: Both the rate of hospital discharge without neurologic impairment (6 percent vs. 2 percent, P = 0.01) and the one-year survival rate (5 percent vs. 2 percent, P = 0.03) were significantly higher among patients who received active compression-decompression CPR than among those who received standard CPR. All patients who survived to one year had cardiac arrests that were witnessed. Nine of 17 one-year survivors in the active compression-decompression group and 2 of 7 in the standard group, respectively, initially had asystole or pulseless electrical activity. In 12 of the 17 survivors who had received active compression-decompression CPR, neurologic status returned to base line, as compared with 3 of 7 survivors who had received standard CPR (P = 0.34). Conclusions: Active compression- decompression CPR performed during advanced life support significantly improved long-term survival rates among patients who had cardiac arrest outside the hospital.
UR - http://www.scopus.com/inward/record.url?scp=0033584459&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033584459&partnerID=8YFLogxK
U2 - 10.1056/NEJM199908193410804
DO - 10.1056/NEJM199908193410804
M3 - Article
C2 - 10451462
AN - SCOPUS:0033584459
SN - 0028-4793
VL - 341
SP - 569
EP - 575
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 8
ER -