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A pilot study of mechanical chest compressions with the LUCAS (TM) device in cardiopulmonary resuscitation
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
2011 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 82, no 6, 702-706 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The LUCASTM device has been shown to improve organ perfusion during cardiac arrest in experimental studies. In this pilot study the aim was to compare short-term survival between cardiopulmonary resuscitation (CPR) performed with mechanical chest compressions using the LUCASTM device and CPR performed with manual chest compressions. The intention was to use the results for power calculation in a larger randomised multicentre trial. Methods: In a prospective pilot study, from February 1, 2005, to April 1, 2007, 149 patients with out-of hospital cardiac arrest in two Swedish cities were randomised to mechanical chest compressions or standard CPR with manual chest compressions. Results: After exclusion, the LUCAS and the manual groups contained 75 and 73 patients, respectively. In the LUCAS and manual groups, spontaneous circulation with a palpable pulse returned in 30 and 23 patients (p = 0.30), spontaneous circulation with blood pressure above 80/50 mmHg remained for at least 5 min in 23 and 19 patients (p = 0.59), the number of patients hospitalised alive >4 h were 18 and 15 (p = 0.69), and the number discharged, alive 6 and 7 (p = 0.78), respectively. Conclusions: In this pilot study of out-of-hospital cardiac arrest patients we found no difference in early survival between CPR performed with mechanical chest compression with the LUCASTM device and CPR with manual chest compressions. Data have been used for power calculation in a forthcoming multicentre trial.

Place, publisher, year, edition, pages
2011. Vol. 82, no 6, 702-706 p.
Keyword [en]
Cardiac arrest, Active compression-decompression (ACD), Cardiopulmonary resuscitation (CPR), Out-of-hospital CPR, Mechanical devices, Survival, Device, LUCAS
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-155215DOI: 10.1016/j.resuscitation.2011.01.032ISI: 000291341500015OAI: oai:DiVA.org:uu-155215DiVA: diva2:425652
Available from: 2011-06-21 Created: 2011-06-20 Last updated: 2017-12-11Bibliographically approved
In thesis
1. Safety with Mechanical Chest Compressions in CPR: Clinical studies with the LUCAS™ device
Open this publication in new window or tab >>Safety with Mechanical Chest Compressions in CPR: Clinical studies with the LUCAS™ device
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Chest compressions in cardiopulmonary resuscitation are of utmost importance although not without a risk. Many injuries are described but the incidence of these is hard to define due to methodological differences. It is strenuous to perform chest compressions and therefore mechanical chest compressions have been looked upon with interest. This thesis presents new insights on the panorama and incidence of injuries in modern CPR and a comparison of safety and efficacy between manual chest compressions and mechanical chest compressions with the LUCAS™ device.

We also evaluated if computed tomography could be an aid in the detection of these injuries.

Two pilot trials were conducted and one presented no difference in early survival with 26% and 31% having return of spontaneous circulation when comparing manual chest compressions with the LUCAS device in out-of-hospital cardiac arrest. The other revealed no difference in autopsy-detected injuries. A third multicentre autopsy trial revealed that in patients treated with manual chest compressions 78.3% had at least one injury and 63.9% had at least one rib fracture. The corresponding numbers for patients treated with the LUCAS device was 92.8% (p = 0.002) and 77.7% (p=0.022). Sternal fractures occurred in 54.2% and in 58.3% of the cases treated with manual chest compressions and the LUCAS device respectively (p = 0.556). The median number of rib fractures was 7 in the group receiving manual chest compressions and 6 in the group receiving chest compressions with the LUCAS device. In 31 cases a computed tomography was conducted prior to autopsy and we found a very strong correlation in the discrimination of patients with or without rib fractures (kappa=0.83). Mean difference between the two methods in detecting rib fractures was 0.16. The detection of other injuries did not have a strong correlation. In conclusion there is no difference in early survival between the two methods and mechanical chest compressions adds 14-15% more patients with rib fractures but the amount of rib fractures, sternal fractures and other injuries is equal. CT can aid but not replace autopsies in the detection of these injuries.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 69 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 922
Keyword
Cardiac arrest, Cardiopulmonary resuscitation, Mechanical chest compressions, Active compression-decompression, Injury, Autopsy, LUCAS
National Category
Other Clinical Medicine
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-204069 (URN)978-91-554-8716-4 (ISBN)
Public defence
2013-09-27, Ebba Enghoffsalen, Ingång 50 bv., Akademiska Sjukhuset, Uppsala, 13:00 (English)
Opponent
Supervisors
Available from: 2013-09-03 Created: 2013-07-21 Last updated: 2014-01-07

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Smekal, DavidJohansson, JakobRubertsson, Sten

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