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Published in: Critical Care 4/2012

Open Access 01-08-2012 | Research

Improved neurologically intact survival with the use of an automated, load-distributing band chest compression device for cardiac arrest presenting to the emergency department

Authors: Marcus Eng Hock Ong, Stephanie Fook-Chong, Annitha Annathurai, Shiang Hu Ang, Ling Tiah, Kok Leong Yong, Zhi Xiong Koh, Susan Yap, Papia Sultana

Published in: Critical Care | Issue 4/2012

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Abstract

Introduction

It has been unclear if mechanical cardiopulmonary resuscitation (CPR) is a viable alternative to manual CPR. We aimed to compare resuscitation outcomes before and after switching from manual CPR to load-distributing band (LDB) CPR in a multi-center emergency department (ED) trial.

Methods

We conducted a phased, prospective cohort evaluation with intention-to-treat analysis of adults with non-traumatic cardiac arrest. At these two urban EDs, systems were changed from manual CPR to LDB-CPR. Primary outcome was survival to hospital discharge, with secondary outcome measures of return of spontaneous circulation, survival to hospital admission and neurological outcome at discharge.

Results

A total of 1,011 patients were included in the study, with 459 in the manual CPR phase (January 01, 2004, to August 24, 2007) and 552 patients in the LDB-CPR phase (August 16, 2007, to December 31, 2009). In the LDB phase, the LDB device was applied in 454 patients (82.3%). Patients in the manual CPR and LDB-CPR phases were comparable for mean age, gender and ethnicity. The mean duration from collapse to arrival at ED (min) for manual CPR and LDB-CPR phases was 34:03 (SD16:59) and 33:18 (SD14:57) respectively. The rate of survival to hospital discharge tended to be higher in the LDB-CPR phase (LDB 3.3% vs Manual 1.3%; adjusted OR, 1.42; 95% CI, 0.47, 4.29). There were more survivors in LDB group with cerebral performance category 1 (good) (Manual 1 vs LDB 12, P = 0.01). Overall performance category 1 (good) was Manual 1 vs LDB 10, P = 0.06.

Conclusions

A resuscitation strategy using LDB-CPR in an ED environment was associated with improved neurologically intact survival on discharge in adults with prolonged, non-traumatic cardiac arrest.
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Metadata
Title
Improved neurologically intact survival with the use of an automated, load-distributing band chest compression device for cardiac arrest presenting to the emergency department
Authors
Marcus Eng Hock Ong
Stephanie Fook-Chong
Annitha Annathurai
Shiang Hu Ang
Ling Tiah
Kok Leong Yong
Zhi Xiong Koh
Susan Yap
Papia Sultana
Publication date
01-08-2012
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2012
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc11456

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