Return of spontaneous circulation after cardiac arrest using mechanical chest compressions with the Lund Cardiac Arrest System compared with manual chest compressions

Introduction

Experimental studies have shown improved organ perfusion with mechanical chest compression with the Lund Cardiac Arrest System (LUCAS) compared with conventional cardiopulmonary resuscitation (CPR). Few data exist on the effects on clinical outcome. From September 2006 onwards, all out-of-hospital resuscitations for cardiac arrest in the Leiden area were performed using the LUCAS in combination with continuous flow insufflations of oxygen (CFI). We studied the effect of the LUCAS-CFI on the return of spontaneous circulation (ROSC) on arrival at the hospital compared with conventional CPR.

Methods

From January 2007 to September 2007, data on ROSC on arrival at the hospital were collected prospectively, and were compared with historical controls, manual CPR, for January 2006–September 2006. Only patients with primary cardiac disease (ischemia or arrhythmias) were included in the analysis. Groups were compared using the chi-square test and the Mann–Whitney test. Potential confounders of the effect of the LUCAS on ROSC were tested in a univariate logistic regression model. In a multivariate logistic regression model, the effect of LUCAS was tested, corrected for confounders.

Results

From January 2007 to September 2007, 57 patients were resuscitated using LUCAS-CFI. Fifty-six patients were used as historical controls. Groups were comparable (Table 1) with the exception of bystander CPR. ROSC occurred in 20 (35%) patients in the LUCAS-CFI group versus 14 (25%) in the control group. In the univariate analysis, asystole significantly decreased the chance of ROSC (OR = 0.21, 95% CI = 0.05–0.96). Corrected for confounders the LUCAS did not perform better than manual chest compression with respect to ROSC (OR = 1.25, 95% CI = 0.53–2.94).

Table 1

Conclusion

We found no significant difference in ROSC between LUCAS-CPR compared with conventional CPR by manual chest compressions.