Study: CPR with Load-Distributing Band Chest Compression Device Improves Survival

2006 AUG 9 - (NewsRx.com) -- Compared with resuscitation using manual cardiopulmonary resuscitation (CPR), a resuscitation strategy using load-distributing band (LDB)-CPR on EMS ambulances is associated with improved survival to hospital discharge in adults with out-of-hospital nontraumatic cardiac arrest.

According to recent research from the United States, "Only 1% to 8% of adults with out-of-hospital cardiac arrest survive to hospital discharge. The objective of this study was to compare resuscitation outcomes before and after an urban emergency medical services (EMS) system switched from manual CPR to LDB-CPR."

M.E.H. Ong and colleagues, Virginia Commonwealth University, wrote, "The study was a phased, observational cohort evaluation with intention-to-treat analysis of 783 adults with out-of-hospital, nontraumatic cardiac arrest. A total of 499 patients were included in the manual CPR phase (January 1, 2001, to March 31, 2003) and 284 patients in the LDB-CPR phase (December 20, 2003, to March 31, 2005); of these patients, the LDB device was applied in 210 patients. The primary outcome measure was return of spontaneous circulation (ROSC), with secondary outcome measures of survival to hospital admission and hospital discharge, and neurological outcome at discharge.

"Patients in the manual CPR and LDB-CPR phases were comparable except for a faster response time interval (mean difference, 26 seconds) and more EMS-witnessed arrests (18.7 vs 12.6%) with LDB. Rates for ROSC and survival were increased with LDB-CPR compared with manual CPR (for ROSC, 34.5%; 95% confidence interval [CI], 29.2-40.3% vs 20.2%; 95% CI, 16.9-24.0%; adjusted odds ratio [OR], 1.94; 95% CI, 1.38-2.72; for survival to hospital admission, 20.9%; 95% CI, 16.6-26.1% vs 11.1%; 95% CI, 8.6-14.2%; adjusted OR, 1.88; 95% CI, 1.23-2.86; and for survival to hospital discharge, 9.7%; 95% CI, 6.7-13.8% vs 2.9%; 95% CI, 1.7-4.8%; adjusted OR, 2.27; 95% CI, 1.11-4.77)."

They continued, "In secondary analysis of the 210 patients in whom the LDB device was applied, 38 patients (18.1%) survived to hospital admission (95% CI, 13.4-23.9%) and 12 patients (5.7%) survived to hospital discharge (95% CI, 3.0-9.3%). Among patients in the manual CPR and LDB-CPR groups who survived to hospital discharge, there was no significant difference between groups in Cerebral Performance Category (p=.36) or Overall Performance Category (p=. 40). The number needed to treat for the adjusted outcome survival to discharge was 15 (95% CI, 9-33)."

The researchers concluded, "Compared with resuscitation using manual CPR, a resuscitation strategy using LDB-CPR on EMS ambulances is associated with improved survival to hospital discharge in adults with out-of-hospital nontraumatic cardiac arrest."

Ong and colleagues published their study in the JAMA - Journal of the American Medical Association (Use of an automated, load-distributing band chest compression device for out-of-hospital cardiac arrest resuscitation. JAMA, 2006;295(22):2629-2637).

For additional information, contact J.P. Ornato, Virginia Commonwealth University, Medical Center, Dept. of Emergency Medicine, 1250E Marshall St., 2nd Floor, Richmond, VA 23298, USA.

Publisher contact information for the JAMA - Journal of the American Medical Association is: American Medical Association, 515 N State St., Chicago, IL 60610-0946, USA.

Keywords: Richmond, Virginia, United States, Ambulance, Cardiac Arrest, Cardiology, Cardiopulmonary Resuscitation, CPR, Emergency Medicine, Load-distributing Band, Medical Device.

This article was prepared by Biotech Week editors from staff and other reports. Copyright 2006, Biotech Week via NewsRx.com.

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