Treatment of non-traumatic out-of-hospital cardiac arrest with active compression decompression cardiopulmonary resuscitation plus an impedance threshold device

Autor: Richard Holcomb, Brian J. O'Neil, Sandi S. Wewerka, Lucinda Klann, Keith G. Lurie, Robert A. Swor, Brian D. Mahoney, Demetris Yannopoulos, Marvin A. Wayne, Robert M. Domeier, Joshua G. Salzman, Nathan Burkhart, David E. Tupper, Ralph J. Frascone, Cindy Setum, Michael L. Olinger, Tom P. Aufderheide
Rok vydání: 2013
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Heart Massage
Kaplan-Meier Estimate
Emergency Nursing
Cardiography
Impedance
Risk Assessment
law.invention
Young Adult
Randomized controlled trial
Reference Values
law
Modified Rankin Scale
Confidence Intervals
Odds Ratio
Clinical endpoint
Humans
Medicine
Hospital Mortality
Prospective Studies
Cardiopulmonary resuscitation
Prospective cohort study
Survival rate
Aged
Aged
80 and over
medicine.diagnostic_test
business.industry
Middle Aged
Impedance threshold device
Combined Modality Therapy
Cardiopulmonary Resuscitation
Patient Discharge
Surgery
Survival Rate
Impedance cardiography
Treatment Outcome
Evaluation Studies as Topic
Anesthesia
Emergency Medicine
Wounds and Injuries
Female
Cardiology and Cardiovascular Medicine
business
Out-of-Hospital Cardiac Arrest
Zdroj: Resuscitation. 84:1214-1222
ISSN: 0300-9572
DOI: 10.1016/j.resuscitation.2013.05.002
Popis: Background A recent out-of-hospital cardiac arrest (OHCA) clinical trial showed improved survival to hospital discharge (HD) with favorable neurologic function for patients with cardiac arrest of cardiac origin treated with active compression decompression cardiopulmonary resuscitation (CPR) plus an impedance threshold device (ACD+ICD) versus standard (S) CPR. The current analysis examined whether treatment with ACD+ITD is more effective than standard (S-CPR) for all cardiac arrests of non-traumatic origin, regardless of the etiology. Methods This is a secondary analysis of data from a randomized, prospective, multicenter, intention-to-treat, OHCA clinical trial. Adults with presumed non-traumatic cardiac arrest were enrolled and followed for one year post arrest. The primary endpoint was survival to hospital discharge (HD) with favorable neurologic function (Modified Rankin Scale score≤3). Results Between October 2005 and July 2009, 2738 patients were enrolled (S-CPR=1335; ACD+ITD=1403). Survival to HD with favorable neurologic function was greater with ACD+ITD compared with S-CPR: 7.9% versus 5.7%, (OR 1.42, 95% CI 1.04, 1.95, p =0.027). One-year survival was also greater: 7.9% versus 5.7%, (OR 1.43, 95% CI 1.04, 1.96, p =0.026). Nearly all survivors in both groups had returned to their baseline neurological function by one year. Major adverse event rates were similar between groups. Conclusions Treatment of out-of-hospital non-traumatic cardiac arrest patients with ACD+ITD resulted in a significant increase in survival to hospital discharge with favorable neurological function when compared with S-CPR. A significant increase survival rates was observed up to one year after arrest in subjects treated with ACD+ITD, regardless of the etiology of the cardiac arrest.
Databáze: OpenAIRE
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