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Mechanical chest compression devices have been shown to provide superior cerebral and coronary blood flow compared with manual compression during cardiopulmonary resuscitation (CPR). In a prospective study, researchers compared rates of chest compression interruptions during CPR before and after an emergency department in Singapore switched from standard manual compression to a mechanical compression device (AutoPulse load-distributing band). The study included 26 adult patients with out-of-hospital nontraumatic cardiac arrest who underwent CPR during several months before the switch and 41 such patients who underwent CPR after the switch; demographic and clinical characteristics were similar between groups. The study was supported by the manufacturer of the compression device.
CPR time was measured in 5-minute intervals, and no-flow time (the sum of all pauses between chest compressions longer than 1.5 seconds) was assessed from video recordings and defibrillator data. Median no-flow times in the manual and mechanical groups, respectively, were 85 and 104 seconds during the first 5 minutes of CPR and 85 and 52 seconds during the next 5 minutes. The average time to apply the device was 152 seconds. Rates of return of spontaneous circulation, survival to hospital admission, and survival to 24, 48, and 72 hours did not differ significantly between groups.
Ong MEH et al. Cardiopulmonary resuscitation interruptions with use of a load-distributing band device during emergency department cardiac arrest. Ann Emerg Med 2010 Sep; 56:233.
Comment
This chest compression device, like most others, improves the quality of chest compressions after it is properly applied but is associated with significant no-flow time while it is being applied. To achieve the benefit of any new device, training must emphasize optimal clinical use, which in this case is to apply the device as rapidly as possible with minimal interruption of CPR.