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Continuous mechanical chest compression during in-hospital cardiopulmonary resuscitation of patients with pulseless electrical activity

Bonnemeier, Hendrik; Simonis, Gregor; Olivecrona, Göran LU ; Weidtmann, Britta; Götberg, Matthias LU ; Weitz, Gunther; Gerling, Ivana; Strasser, Ruth and Frey, Norbert (2011) In Resuscitation 82(2). p.155-159
Abstract
Survival after in-hospital pulseless electrical activity (PEA) cardiac arrest is poor and has not changed during the last 10 years. Effective chest compressions may improve survival after PEA. We investigated whether a mechanical device (LUCAS (TM)-CPR) can ensure chest compressions during cardiac arrest according to guidelines and without interruption during transport, diagnostic procedures and in the catheter laboratory. Methods: We studied mechanical chest compression in 28 patients with PEA (pulmonary embolism (PE) n = 14; cardiogenic shock/acute myocardial infarction; n=9; severe hyperkalemia; n=2; sustained ventricular arrhythmias/electrical storm; n=3) in a university hospital setting. Results: During or immediately after CPR, 21... (More)
Survival after in-hospital pulseless electrical activity (PEA) cardiac arrest is poor and has not changed during the last 10 years. Effective chest compressions may improve survival after PEA. We investigated whether a mechanical device (LUCAS (TM)-CPR) can ensure chest compressions during cardiac arrest according to guidelines and without interruption during transport, diagnostic procedures and in the catheter laboratory. Methods: We studied mechanical chest compression in 28 patients with PEA (pulmonary embolism (PE) n = 14; cardiogenic shock/acute myocardial infarction; n=9; severe hyperkalemia; n=2; sustained ventricular arrhythmias/electrical storm; n=3) in a university hospital setting. Results: During or immediately after CPR, 21 patients underwent coronary angiography and or pulmonary angiography. Successful return of a spontaneous circulation (ROSC) was achieved in 27 out of the 28 patients. Ten patients died within the first hour and three patients died within 2411 after CPR. A total of 14 patients survived and were discharged from hospital (13 without significant neurological deficit). Interestingly, six patients with PE did not have thrombolytic therapy due to contraindications. CT-angiography findings in these patients showed fragmentation of the thrombus suggesting thrombus breakdown as an additional effect of mechanical chest compressions. No patients exhibited any life-threatening device-related complications. Conclusion: Continuous chest compression with an automatic mechanical device is feasible, safe, and might improve outcomes after in-hospital-resuscitation of PEA. Patients with PE may benefit from effective continuous chest compression, probably due to thrombus fragmentation and increased pulmonary artery blood flow. (C) 2010 Elsevier Ireland Ltd. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiopulmonary resuscitation, Mechanical chest compression device, Pulseless electrical activity
in
Resuscitation
volume
82
issue
2
pages
155 - 159
publisher
Elsevier
external identifiers
  • wos:000287561400004
  • scopus:78751575730
ISSN
1873-1570
DOI
10.1016/j.resuscitation.2010.10.019
language
English
LU publication?
yes
id
148999f6-eef5-4403-b171-b7f65e77d222 (old id 1870044)
date added to LUP
2011-04-04 08:29:17
date last changed
2017-07-09 03:14:37
@article{148999f6-eef5-4403-b171-b7f65e77d222,
  abstract     = {Survival after in-hospital pulseless electrical activity (PEA) cardiac arrest is poor and has not changed during the last 10 years. Effective chest compressions may improve survival after PEA. We investigated whether a mechanical device (LUCAS (TM)-CPR) can ensure chest compressions during cardiac arrest according to guidelines and without interruption during transport, diagnostic procedures and in the catheter laboratory. Methods: We studied mechanical chest compression in 28 patients with PEA (pulmonary embolism (PE) n = 14; cardiogenic shock/acute myocardial infarction; n=9; severe hyperkalemia; n=2; sustained ventricular arrhythmias/electrical storm; n=3) in a university hospital setting. Results: During or immediately after CPR, 21 patients underwent coronary angiography and or pulmonary angiography. Successful return of a spontaneous circulation (ROSC) was achieved in 27 out of the 28 patients. Ten patients died within the first hour and three patients died within 2411 after CPR. A total of 14 patients survived and were discharged from hospital (13 without significant neurological deficit). Interestingly, six patients with PE did not have thrombolytic therapy due to contraindications. CT-angiography findings in these patients showed fragmentation of the thrombus suggesting thrombus breakdown as an additional effect of mechanical chest compressions. No patients exhibited any life-threatening device-related complications. Conclusion: Continuous chest compression with an automatic mechanical device is feasible, safe, and might improve outcomes after in-hospital-resuscitation of PEA. Patients with PE may benefit from effective continuous chest compression, probably due to thrombus fragmentation and increased pulmonary artery blood flow. (C) 2010 Elsevier Ireland Ltd. All rights reserved.},
  author       = {Bonnemeier, Hendrik and Simonis, Gregor and Olivecrona, Göran and Weidtmann, Britta and Götberg, Matthias and Weitz, Gunther and Gerling, Ivana and Strasser, Ruth and Frey, Norbert},
  issn         = {1873-1570},
  keyword      = {Cardiopulmonary resuscitation,Mechanical chest compression device,Pulseless electrical activity},
  language     = {eng},
  number       = {2},
  pages        = {155--159},
  publisher    = {Elsevier},
  series       = {Resuscitation},
  title        = {Continuous mechanical chest compression during in-hospital cardiopulmonary resuscitation of patients with pulseless electrical activity},
  url          = {http://dx.doi.org/10.1016/j.resuscitation.2010.10.019},
  volume       = {82},
  year         = {2011},
}