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Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) achieves greater negative intrathoracic pressure during the decompression phase than standard CPR. In a prospective industry-sponsored study that involved 46 U.S. emergency medical services (EMS) systems, 1653 adults with nontraumatic cardiac arrest were randomized to receive either standard CPR or ACD-CPR with augmentation of negative intrathoracic pressure during decompression via an impedance-threshold device attached to the face mask. ACD-CPR was performed with a hand-held suction cup device containing a metronome and force gauge to guide depth and timing of compressions.
The rate of survival to hospital discharge with modified Rankin scale score ≤3 (the primary out…