Research Article

Comparative Hemodynamic Evaluation of the LUCAS® Device and Manual Chest Compression in Patients with Out-of-Hospital Cardiac Arrest

Mirek S, Opprecht N*, Daisey A, Milojevitch E, Soudry- Faure A and Freysz M

Published: 04/19/2017 | Volume 2 - Issue 1 | Pages: 016-024

INTRODUCTION

Chest compression is the fundamental technique in cardiopulmonary resuscitation (CPR) in patients with cardiac arrest [1]. The quality and the early implementation of CPR are essential to improve the prognosis and the chances of restoring spontaneous circulation. In the literature, there are some articles about the poor quality of chest compression [2-4]. Therefore chest compression is as crucial as alerting the emergency services or early defibrillation in the survival chain. In accordance with the guidelines, chest compressions have to be performed continuously to improve the outcome [5]. However, the efficacy of manual chest compression diminishes over time with the fatigue of the provider (which appears within minutes of starting the procedure), and is impaired during transportation manoeuvres, which expose patients to unforeseen interruptions and a deterioration in the quality du massage in terms of power and rhythm. The efficacy of manual chest compression has been reported to fall by 20% per minute [6,7]. Mechanical chest compression overcome this problem of operator fatigue by ensuring constant efficacy in terms of both quality and quantity. Even though current data show no difference between manual chest compression and automated systems in terms of survival, haemodynamic studies in animal models have shown that mechanical techniques are more effective [8].

The principal aim of this study was to evaluate the hemodynamic impact (systolic, diastolic and mean arterial blood pressure) of the LUCAS™ active compression-decompression device (Medtronics® Jolife; Lund, Sweden) as the mechanical chest compression technique versus manual chest compression. The secondary aims were on the one hand to evaluate in a quantitative manner cardiac output and its evolution during mechanical and manual cardiopulmonary resuscitation and on the other hand to evaluate the correlation between cardiac output and other routinely-measured hemodynamic parameters, in particular the EtCO2.

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