Evaluation of an impedance threshold device in patients receiving active compression-decompression cardiopulmonary resuscitation for out of hospital cardiac arrest

Patrick Plaisance, Keith G. Lurie, Eric Vicaut, Dominique Martin, Pierre Yves Gueugniaud, Jean Luc Petit, Didier Payen

Research output: Contribution to journalArticlepeer-review

107 Scopus citations

Abstract

Aims: The purpose of this multicentre clinical randomized controlled blinded prospective trial was to determine whether an inspiratory impedance threshold device (ITD), when used in combination with active compression-decompression (ACD) cardiopulmonary resuscitation (CPR), would improve survival rates in patients with out-of-hospital cardiac arrest. Methods and results: Patients were randomized to receive either a sham (n=200) or an active impedance threshold device (n=200) during advanced cardiac life support performed with active compression-decompression cardiopulmonary resuscitation. The primary endpoint of this study was 24 h survival. The 24 h survival rates were 44/200 (22%) with the sham valve and 64/200 (32%) with the active valve (P=0.02). The number of patients who had a return of spontaneous circulation (ROSC), intensive care unit (ICU) admission, and hospital discharge rates was 77 (39%), 57 (29%), and 8 (4%) in the sham valve group versus 96 (48%) (P=0.05), 79 (40%) (P=0.02), and 10 (5%) (P=0.6) in the active valve group. Six out of ten survivors in the active valve group and 1/8 survivors in the sham group had normal neurological function at hospital discharge (P=0.1). Conclusion: The use of an impedance valve in patients receiving active compression-decompression cardiopulmonary resuscitation for out-of-hospital cardiac arrest significantly improved 24 h survival rates.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalResuscitation
Volume61
Issue number3
DOIs
StatePublished - Jun 1 2004

Keywords

  • Active compression-decompression
  • Cardiac arrest
  • Cardiopulmonary resuscitation (CPR)
  • Compresão-descompressão activa
  • Impedance threshold device
  • Outcome
  • Paragem cardíaca
  • Reanimação cardio-pulmonar (CPR)

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