Resuscitation
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Randomized Controlled Trial Clinical Trial
Active compression-decompression cardiopulmonary resuscitation in standing position over the patient: pros and cons of a new method.
Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) has been introduced to improve outcome of CPR after cardiac arrest. Usually, ACD-CPR is performed with the rescuer kneeling beside the patient (ACD-B), but ACD-CPR with the rescuer in standing position (ACD-S) has been taught and applied in some centres in addition to conventional ACD-CPR (ACD-B). The aim of this randomised and cross-over study was to evaluate the new technique of ACD-S and to compare it with conventional ACD-B. ⋯ Compression forces decreased in ACD-S from 55.1 to 48.9 kp (P = 0.002) and in ACD-B from 52.8 to 47.0 kp (P = 0.069). We conclude that ACD-CPR in standing position can be considered equal to ACD-B in view of maximal duration of CPR, exhaustion of the rescuers and decompression forces. The decrease of compression forces in ACD-S and ACD-B as well as the difference between compression forces in ACD-S and ACD-B seem to be of no clinical relevance, and exhaustion was judged to be similar despite oxygen consumption being higher in ACD-S than in ACD-B.
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Randomized Controlled Trial Comparative Study Clinical Trial
Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) compared with standard CPR in a manikin model--decompression force, compression rate, depth and duration.
During active compression-decompression cardiopulmonary resuscitation (ACD-CPR), the rescuer applies traction to the chest between compressions. Under experimental conditions, cardiac output increases, possibly through accentuated intrathoracal pressure fluctuations. ACD-CPR requires specific training and may be more complex to perform than standard CPR. ⋯ ACD-CPR when compared with standard CPR causes a consistent and significant reduction of compression rate, depth and duration. These are all factors of possible clinical significance. Training in ACD-CPR should address this issue, with special emphasis on optimal decompression force and ECC rate.