Abstract

Research Article

Comparative Hemodynamic Evaluation of the LUCAS® Device and Manual Chest Compression in Patients with Out-of-Hospital Cardiac Arrest

Mirek S, Opprecht N*, Daisey A, Milojevitch E, Soudry- Faure A and Freysz M

Published: 19 April, 2017 | Volume 2 - Issue 1 | Pages: 016-024

Chest compression is the fundamental technique in cardiopulmonary resuscitation (CPR) in patients with cardiac arrest [1]. The quality and the early implementation of CPR are essential to improve the prognosis and the chances of restoring spontaneous circulation. In the literature, there are some articles about the poor quality of chest compression [2-4]. Therefore chest compression is as crucial as alerting the emergency services or early defibrillation in the survival chain. In accordance with the guidelines, chest compressions have to be performed continuously to improve the outcome [5]. However, the efficacy of manual chest compression diminishes over time with the fatigue of the provider (which appears within minutes of starting the procedure), and is impaired during transportation manoeuvres, which expose patients to unforeseen interruptions and a deterioration in the quality du massage in terms of power and rhythm. The efficacy of manual chest compression has been reported to fall by 20% per minute [6,7]. Mechanical chest compression overcome this problem of operator fatigue by ensuring constant efficacy in terms of both quality and quantity. Even though current data show no difference between manual chest compression and automated systems in terms of survival, haemodynamic studies in animal models have shown that mechanical techniques are more effective [8].

Read Full Article HTML DOI: 10.29328/journal.jcicm.1001005 Cite this Article Read Full Article PDF

References

  1. Perkins GD, Lall R, Quinn T, Deakin CD, Cooke MW, et al. Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. Lancet. 2015; 385: 947-955. Ref.: https://goo.gl/9Cu42Y
  2. Wik L, Kramer-Johansen J, Myklebust H, Sørebø H, Svensson L, et al. Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA. 2005; 293: 299-304. Ref.: https://goo.gl/Csd5aN
  3. Abella BS, Alvarado JP, Myklebust H, Edelson DP, Barry A, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA. 2005; 293: 305-310. Ref.: https://goo.gl/1WyPwL
  4. Kampmeier TG, Lukas RP, Steffler C, Sauerland C, Weber TP, et al. Chest compression depth after change in CPR guidelines--improved but not sufficient. Resuscitation. 2014; 85: 503-508. Ref.: https://goo.gl/HI9168
  5. Ewy GA. Continuous-chest-compression cardiopulmonary resuscitation for cardiac arrest. Circulation. 2007; 116: 2894-2896. Ref.: https://goo.gl/VhWTrW
  6. Hightower D, Thomas SH, Stone CK, Dunn K, March JA. Decay in quality of closed-chest compressions over time. Ann Emerg Med. 1995; 26: 300-303. Ref.: https://goo.gl/zrYbi5
  7. Ock SM, Kim YM, Chung Jh, Kim SH. Influence of physical fitness on the performance of 5-minute continuous chest compression. Eur J Emerg Med. 2011; 18: 251-256. Ref.: https://goo.gl/nqsory
  8. Gässler H, Ventzke MM, Lampl L, Helm M. Transport with ongoing resuscitation: a comparison between manual and mechanical compression. Emerg Med J. 2013; 30: 589-592. Ref.: https://goo.gl/OgjC5O
  9. Nathens AB, Brunet FP, Maier RV. Development of trauma systems and effect on outcomes after injury. Lancet. 2004; 363: 1794-1801. Ref.: https://goo.gl/XY56BC
  10. Yeguiayan JM, Garrigue D, Binquet C, Jacquot C, Duranteau J, et al. Medical pre-hospital management reduces mortality in severe blunt trauma: a prospective epidemiological study. Crit Care. 2011; 15: R34. Ref.: https://goo.gl/cewDpP
  11. Duchateau FX, Gueye P, Curac S, Tubach F, Broche C, et al. Effect of the AutoPulse automated band chest compression device on hemodynamics in out-of-hospital cardiac arrest resuscitation. Intensive Care Med. 2010; 36: 1256-1260. Ref.: https://goo.gl/Z0KM0L
  12. Nolan JP, Soar J, Zideman DA, Biarent D, Bossaert LL, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. Resuscitation. 2010; 81: 1219-1276. Ref.: https://goo.gl/HXOvJi
  13. Steen S, Liao Q, Pierre L, Paskevicius A, Sjöberg T. Continuous intratracheal insufflation of oxygen improves the efficacy of mechanical chest compression-active decompression CPR. Resuscitation. 2004; 62: 219-227. Ref.: https://goo.gl/NxfsKQ
  14. Sende J, Jabre P, Leroux B, Penet C, Lecarpentier E, et al. Invasive arterial blood pressure monitoring in an out-of-hospital setting: an observational study. Emerg Med J. 2009; 26: 210-212. Ref.: https://goo.gl/FwVGFr
  15. Bertrand C, Hemery F, Carli P, Goldstein P, Espesson C, et al. Constant flow insufflation of oxygen as the sole mode of ventilation during out-of-hospital cardiac arrest. Intensive Care Med. 2006; 32: 843-851. Ref.: https://goo.gl/7xOG8u
  16. Horster S, Stemmler HJ, Strecker N, Brettner F, Hausmann A, et al. Cardiac Output Measurements in Septic Patients: Comparing the Accuracy of USCOM to PiCCO. Crit Care Res Pract. 2012; 2012: 270631. Ref.: https://goo.gl/dkIXVM
  17. Phillips R, Lichtenthal P, Sloniger J, Burstow D, West M, et al. Noninvasive cardiac output measurement in heart failure subjects on circulatory support. Anesth Analg. 2009; 108: 881-886. Ref.: https://goo.gl/C1AqKK
  18. Duchateau FX, Gauss T, Burnod A, Ricard-Hibon A, Juvin P, et al. Feasibility of cardiac output estimation by ultrasonic cardiac output monitoring in the prehospital setting. Eur J Emerg Med. 2011; 18: 357-359. Ref.: https://goo.gl/pyuNgP
  19. Gueugniaud PY, David JS, Chanzy E, Hubert H, Dubien PY, et al. Vasopressin and epinephrine vs. epinephrine alone in cardiopulmonary resuscitation. N Engl J Med. 2008; 359: 21-30. Ref.: https://goo.gl/R4ro2G
  20. Goldberger ZD, Chan PS, Berg RA, Kronick SL, Cooke CR, et al. Duration of resuscitation efforts and survival after in-hospital cardiac arrest: an observational study. Lancet. 2012; 380: 1473-1481. Ref.: https://goo.gl/oGWMSE
  21. Reynolds JC, Frisch A, Rittenberger JC, Callaway CW. Duration of resuscitation efforts and functional outcome after out-of-hospital cardiac arrest: when should we change to novel therapies? Circulation. 2013; 128: 2488-2494. Ref.: https://goo.gl/BXPWjT
  22. Sunde K, Wik L, Naess PA, Grund F, Nicolaysen G, et al. Improved haemodynamics with increased compression-decompression rates during ACD-CPR in pigs. Resuscitation. 1998; 39: 197-205. Ref.: https://goo.gl/kp1rrt
  23. Westfall M, Krantz S, Mullin C, Kaufman C. Mechanical versus manual chest compressions in out-of-hospital cardiac arrest: a meta-analysis. Crit Care Med. 2013; 41: 1782-1789. Ref.: https://goo.gl/WoRjK0
  24. Rubertsson S, Karlsten R. Increased cortical cerebral blood flow with LUCAS; a new device for mechanical chest compressions compared to standard external compressions during experimental cardiopulmonary resuscitation. Resuscitation. 2005; 65: 357-363. Ref.: https://goo.gl/uNWXnw
  25. Liao Q, Sjöberg T, Paskevicius A, Wohlfart B, Steen S. Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs. BMC Cardiovasc Disord. 2010; 10: 53. Ref.: https://goo.gl/jowCDI
  26. Larsen AI, Hjørnevik AS, Ellingsen CL, Nilsen DWT. Cardiac arrest with continuous mechanical chest compression during percutaneous coronary intervention. A report on the use of the LUCAS device. Resuscitation. 2007; 75: 454-459. Ref.: https://goo.gl/czdLw7
  27. Liu Q, Li C. [The effect of the external chest compression appliance (AutoPulse) on cardiac arrest in the emergency department and influence on blood gas and N-terminal B-type natriuretic peptide]. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2010; 22: 660-662. Ref.: https://goo.gl/JE5JXI
  28. Smekal D, Lindgren E, Sandler H, Johansson J, Rubertsson S. CPR-related injuries after manual or mechanical chest compressions with the LUCASTM device: a multicentre study of victims after unsuccessful resuscitation. Resuscitation. 2014; 85: 1708-1712. Ref.: https://goo.gl/ZLSE8z
  29. Axelsson C, Karlsson T, Axelsson AB, Herlitz J. Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) versus manual CPR according to pressure of end tidal carbon dioxide (P(ET) CO2) during CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation. 2009; 80: 1099-1103. Ref.: https://goo.gl/Ld2fJh
  30. Dickinson ET, Verdile VP, Schneider RM, Salluzzo RF. Effectiveness of mechanical versus manual chest compressions in out-of-hospital cardiac arrest resuscitation: a pilot study. Am J Emerg Med. 1998; 16: 289-292. Ref.: https://goo.gl/qU0cX5
  31. Tanabe Y, Hosaka Y, Ito M, Ito E, Suzuki K. Significance of end-tidal P(CO(2)) response to exercise and its relation to functional capacity in patients with chronic heart failure. Chest. 2001; 119: 811-817. Ref.: https://goo.gl/kiHQNb
  32. Travers AH, Perkins GD, Berg RA, Castren M, Considine J, et al. Part 3: Adult Basic Life Support and Automated External Defibrillation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2015; 132: 51-83. Ref.: https://goo.gl/AxH4Dk
  33. Gates S, Smith JL, Ong GJ, Brace SJ, Perkins GD. Effectiveness of the LUCAS device for mechanical chest compression after cardiac arrest: systematic review of experimental, observational and animal studies. Heart. 2012; 98: 908-913. Ref.: https://goo.gl/TVfh9C
  34. Fox J, Fiechter R, Gerstl P, Url A, Wagner H, et al. Mechanical versus manual chest compression CPR under ground ambulance transport conditions. Acute Card Care. 2013; 15: 1-6. Ref.: https://goo.gl/jiPGie

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