Active decompression improves the haemodynamic state during cardiopulmonary resuscitation.

OBJECTIVE: To examine whether use of the active compression-decompression device improves the haemodynamics of cardiopulmonary resuscitation compared with those of conventional cardiopulmonary resuscitation.

DESIGN: Prospective crossover study.

SETTING: The accident and emergency department of a university teaching hospital.

PATIENTS: 36 adult patients with non-traumatic, normothermic, out of hospital cardiac arrest.

INTERVENTIONS: Cardiopulmonary resuscitation was performed during resuscitation in alternating 3 min cycles of conventional and active compression-decompression cardiopulmonary resuscitation.

MAIN OUTCOME MEASURES: The end tidal carbon dioxide (ETCO2), femoral arterial pressure, and acid-base analysis of central venous blood measured during the last 30 s of each 3 minute cardiopulmonary resuscitation cycle.

RESULTS: ETCO2 was monitored in 36 patients during conventional and active compression-decompression cardiopulmonary resuscitation. Active compression-decompression cardiopulmonary resuscitation caused a significant increase in ETCO2 (P < 0.0002), indicating improved cardiac output. Arterial pressure measurement was carried out in 10 patients. Systolic pressure was significantly greater with active compression-decompression than conventional cardiopulmonary resuscitation (P < 0.007). Central venous blood was taken for acid-base analysis in 11 patients. There was a significant increase in the central venous hydrogen ion concentration (P = 0.025) with rises in the partial pressures of carbon dioxide and oxygen, suggesting improved venous return.

CONCLUSIONS: This study confirms that active compression-decompression cardiopulmonary resuscitation is associated with better haemodynamic status than conventional resuscitation.