Active chest compression-decompression for cardiopulmonary resuscitation
Evidence SummariesLevel of Evidence = A
Active chest compression-decompression in patients with cardiac arrest is not associated with any benefit compared with standard cardiopulmonary resuscitation.
A Cochrane review 1 included 10 studies with a total of 4,988 subjects; 8 were in out-of-hospital settings; 1 was set in-hospital only; and 1 had both in-hospital and out-of-hospital components. The 2 in-hospital studies found no differences between active compression-decompression cardiopulmonary resuscitation and standard manual cardiopulmonary resuscitation in any outcome.
Out-of-hospital trials included 4162 participants. There were no differences in mortality between active chest compression-decompression and routine cardiopulmonary resuscitation for either immediate (RR 0.98, 95% CI 0.94 to 1.03) or at hospital discharge (OR 0.99, 95% CI 0.98 to 1.01). The pooled RR of neurological impairment of any severity was 1.71 (95% CI 0.90 to 3.25), with a non-significant trend to more frequent severe neurological damage in survivors of active compression-decompression resuscitation (RR 3.11, 95% CI 0.98 to 9.83).
There was no difference between active compression-decompression resuscitation and standard manual cardiopulmonary resuscitation with regard to complications such as rib or sternal fractures, pneumothorax, or haemothorax (RR 1.09, 95% CI 0.86 to 1.38). Skin trauma and ecchymosis were more frequent with active compression-decompression resuscitation .
1. Lafuente-Lafuente C, Melero-Bascones M. Active chest compression-decompression for cardiopulmonary resuscitation. Cochrane Database Syst Rev 2013;(9):CD002751. [PMID:24052483]
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