The Ontario trial of active compression-decompression cardiopulmonary resuscitation for in-hospital and prehospital cardiac arrest
I. G. Stiell, P. C. Hebert, G. A. Wells, A. Laupacis, K. Vandemheen, J. F. Dreyer, M. A. Eisenhauer, J. Gibson, L. A. Higginson, A. S. Kirby, J. L. Mahon, J. P. Maloney and B. N. Weitzman
Division of Emergency Medicine, University of Ottawa, Ontario, Canada.
OBJECTIVE--To compare the impact of active compression-decompression (ACD)
cardiopulmonary resuscitation (CPR) and standard CPR on the outcomes of
in-hospital and prehospital victims of cardiac arrest. DESIGN--Randomized
controlled trial with blinding of allocation using a sealed container.
SETTINGS--(1) Emergency departments, wards, and intensive care units of 5
university hospitals and (2) all locations outside hospitals in 2 midsized
cities. PATIENTS--A total of 1784 adults who had cardiac arrest.
INTERVENTION--Patients received either standard or ACD CPR throughout
resuscitation. MAIN OUTCOME MEASURES--Survival for 1 hour and to hospital
discharge and the modified Mini-Mental State Examination (MMSE).
RESULTS--All characteristics were similar in the standard and ACD CPR
groups for the 773 in-hospital patients and the 1011 prehospital patients.
For in-hospital patients, there were no significant differences between the
standard (n = 368) and ACD (n = 405) CPR groups in survival for 1 hour
(35.1% vs 34.6%; P = .89), in survival until hospital discharge (11.4% vs
10.4%; P = .64), or in the median MMSE score of survivors (37 in both
groups). For patients who collapsed outside the hospital, there were also
no significant differences between the standard (n = 510) and ACD (n = 501)
CPR groups in survival for 1 hour (16.5% vs 18.2%; P = .48), in survival to
hospital discharge (3.7% vs 4.6%; P = .49), or in the median MMSE score of
survivors (35 in both groups). Exploration of clinically important
subgroups failed to identify any patients who appeared to benefit from ACD
CPR. CONCLUSIONS--ACD CPR did not improve survival or neurologic outcomes
in any group of patients with cardiac arrest.
Acute management of sudden cardiac death in adults based upon the new CPR guidelines
Yannopoulos and Aufderheide
Europace 2007;9:2-9.
ABSTRACT
| FULL TEXT
Part 6: CPR Techniques and Devices
Circulation 2005;112:IV-47-IV-50.
FULL TEXT
A 2-Tiered Approach to In-Hospital Defibrillation: Nurses Respond to a Trial of Using Automated External Defibrillators as Part of a Code-Team Protocol
Kyller and Johnstone
Crit Care Nurse 2005;25:25-33.
FULL TEXT
Validation of a Clinical Decision Aid to Discontinue In-Hospital Cardiac Arrest Resuscitations
van Walraven et al.
JAMA 2001;285:1602-1606.
ABSTRACT
| FULL TEXT
New Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care: Changes in the Management of Cardiac Arrest
Kern et al.
JAMA 2001;285:1267-1269.
FULL TEXT
Emergency cardiac care: introduction
Ewy and Ornato
J Am Coll Cardiol 2000;35:825-880.
FULL TEXT
CPR Techniques That Combine Chest and Abdominal Compression and Decompression : Hemodynamic Insights From a Spreadsheet Model
Babbs
Circulation 1999;100:2146-2152.
ABSTRACT
| FULL TEXT
A Comparison of Standard Cardiopulmonary Resuscitation and Active Compression-Decompression Resuscitation for Out-of-Hospital Cardiac Arrest
Plaisance et al.
NEJM 1999;341:569-575.
ABSTRACT
| FULL TEXT
Quality of Survival After Cardiopulmonary Resuscitation
de Vos et al.
Arch Intern Med 1999;159:249-254.
ABSTRACT
| FULL TEXT
Do We Need a Clinical Decision Rule for the Discontinuation of Cardiac Arrest Resuscitations?
Sanders
Arch Intern Med 1999;159:119-121.
FULL TEXT
Derivation of a Clinical Decision Rule for the Discontinuation of In-Hospital Cardiac Arrest Resuscitations
van Walraven et al.
Arch Intern Med 1999;159:129-134.
ABSTRACT
| FULL TEXT
The 1998 European Resuscitation Council guidelines for adult advanced life support
Advanced Life Support Working Group of the Europea
BMJ 1998;316:1863-1869.
FULL TEXT
Similar Outcomes for Standard and ACD CPR
Journal Watch Cardiology 1996;1996:3-3.
FULL TEXT
DISAPPOINTING DATA ON ACTIVE COMPRESSION-DECOMPRESSION CPR
JWatch General 1996;1996:3-3.
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