Resuscitation
Volume 71, Issue 1 , Pages 47-55, October 2006

Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of out-of-hospital cardiac arrest—A pilot study☆

  • Christer Axelsson

      Affiliations

    • Gothenburg EMS-system, Box 5204, SE-402 24 Göteborg, Sweden
    • Corresponding Author InformationCorresponding author. Tel.: +46 705 400 304.
    • ,
  • Johan Nestin

      Affiliations

    • Samariten EMS-system, Huddinge Fire station, SE-141 41 Huddinge, Sweden
    • ,
  • Leif Svensson

      Affiliations

    • Division of Cardiology, South Hospital, SE-118 83 Stockholm, Sweden
    • ,
  • Åsa B. Axelsson

      Affiliations

    • Sahlgrenska Academy, Institute of Health and Care Sciences, Box 457, SE-405 30 Göteborg, Sweden
    • ,
  • Johan Herlitz

      Affiliations

    • Department of Metabolism and Cardiovascular Research, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden

Received 13 January 2006; accepted 16 February 2006.

Summary 

Aim

To evaluate the outcome among patients suffering from out-of-hospital cardiac arrest (OHCA) after the introduction of mechanical chest compression (MCC) compared with standard cardiopulmonary resuscitation (SCPR) in two emergency medical service (EMS) systems.

Methods

The inclusion criterion was witnessed OHCA. The exclusion criteria were age <18 years, the following judged etiologies behind OHCA: trauma, pregnancy, hypothermia, intoxication, hanging and drowning or return of spontaneous circulation (ROSC) prior to the arrival of the advanced life support (ALS) unit. Two MCC devices were allocated during six-month periods between four ALS units for a period of two years (cluster randomisation).

Results

In all, 328 patients fulfilled the criteria for participation and 159 were allocated to the MCC tier (the device was used in 66% of cases) and 169 to the SCPR tier.

In the MCC tier, 51% had ROSC (primary end-point) versus 51% in the SCPR tier. The corresponding values for hospital admission alive (secondary end-point) were 38% and 37% (NS).

In the subset of patients in whom the device was used, the percentage who had ROSC was 49% versus 50% in a control group matched for age, initial rhythm, aetiology, bystander-/crew-witnessed status and delay to CPR. The percentage of patients discharged alive from hospital after OHCA was 8% versus 10% (NS) for all patients and 2% versus 4%, respectively (NS) for the patients in the subset (where the device was used and the matched control population).

Conclusion

In this pilot study, the results did not support the hypothesis that the introduction of mechanical chest compression in OHCA improves outcome. However, there is room for further improvement in the use of the device. The hypothesis that this will improve outcome needs to be tested in further prospective trials.

Keywords: Cardiac arrest, Mechanical chest compression, Prognosis

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

☆ A Spanish translated version of the summary of this article appears as Appendix in the online version at doi:10.1016/j.resuscitation.2006.02.011.

PII: S0300-9572(06)00094-3

doi:10.1016/j.resuscitation.2006.02.011

Resuscitation
Volume 71, Issue 1 , Pages 47-55, October 2006

Article Tools

* Image Usage & Resolution