Plaisance P, Adnet F, Vicaut E, Hennequin B, Magne P, Prudhomme C, Lambert Y, Cantineau J P, Léopold C, Ferracci C, Gizzi M, Payen D
Department of Anesthesiology and Critical Care, Lariboisière University Hospital, Paris, France.
Circulation. 1997 Feb 18;95(4):955-61. doi: 10.1161/01.cir.95.4.955.
We compared short-term prognosis of active compression-decompression (ACD) and standard (STD) cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrests.
We randomized advanced cardiac life support (ACLS) with ACD ACLS CPR on odd days and STD ACLS CPR on even days. We measured the rates of return of spontaneous circulation (ROSC), survival at 1 hour (H1), at 24 hours (H24), and at 1 month (D30): hospital discharge (HD); neurological outcome; and complications. Mean times from collapse to basic cardiac life support CPR was 9 minutes and from collapse to ACLS CPR was 21 minutes. Compared with the STD ACLS patients (n = 258), ACD ACLS patients (n = 254) had higher survival rates (ROSC, 44.9% versus 29.8%, P = .0004; H1, 36.6% versus 24.8%, P = .003; H24, 26% versus 13.6%, P = .002; HD without neurological impairment, 5.5% versus 1.9%, P = .03) and a trend for improvement in neurological outcome at D30 (Glasgow-Pittsburgh Outcome Categories = 1.6 +/- 0.8 versus 2.3 +/- 1.1. P = .09). Sternal dislodgements (2.9% versus 0.4%, P = .03) and hemoptysis (5.4% versus 1.3%, P = .01) were more frequent in the ACD ACLS group.
Despite long time intervals, ACD significantly improved short-term survival rates in out-of-hospital cardiac arrests compared with STD CPR.
我们比较了院外心脏骤停时主动按压-减压（ACD）心肺复苏术（CPR）与标准（STD）CPR的短期预后。
我们进行随机分组，在奇数日采用ACD高级心脏生命支持（ACLS）CPR，在偶数日采用STD ACLS CPR。我们测量了自主循环恢复（ROSC）率、1小时（H1）、24小时（H24）和1个月（D30）时的生存率、出院率（HD）、神经功能转归及并发症。从心脏停搏到基础生命支持CPR的平均时间为9分钟，从心脏停搏到ACLS CPR的平均时间为21分钟。与STD ACLS患者（n = 258）相比，ACD ACLS患者（n = 254）的生存率更高（ROSC，44.9%对29.8%，P = .0004；H1，36.6%对24.8%，P = .003；H24，26%对13.6%，P = .002；无神经功能障碍的HD，5.5%对1.9%，P = .03），且D30时神经功能转归有改善趋势（格拉斯哥-匹兹堡转归分类=1.6±0.8对2.3±1.1，P = .09）。ACD ACLS组胸骨移位（2.9%对0.4%，P = .03）和咯血（5.4%对1.3%，P = .01）更为常见。
尽管时间间隔较长，但与STD CPR相比，ACD显著提高了院外心脏骤停的短期生存率。
