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

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.

• Authors: Patrick Plaisance, Keith G Lurie, Eric Vicaut, Dominique Martin, Pierre-Yves Gueugniaud, Jean-Luc Petit, Didier Payen
• Journal: Resuscitation (Resuscitation) Vol. 61 Issue 3 Pg. 265-71 (Jun 2004) ISSN: 0300-9572 [Print] Ireland
• PMID: 15172704 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Cardiopulmonary Resuscitation (adverse effects, methods)
• Double-Blind Method
• Electric Countershock
• Emergency Medical Services
• Female
• Heart Arrest (mortality, therapy)
• Heart Massage (adverse effects)
• Humans
• Male
• Middle Aged
• Respiration, Artificial (adverse effects, instrumentation, methods)
• Survival Rate