Effect of Interposed Abdominal Compression on Cardiopulmonary Resuscitation Outcomes; a Randomized Clinical Trial
学术急诊医学档案,
卷 10 编号 1 (2022),
1 一月 2022
,
第 e57 页
https://doi.org/10.22037/aaem.v10i1.1678
摘要
Introduction: Standard cardiopulmonary resuscitation (STD-CPR) is successful in only 10-15% of cases in emergency department (ED). This study aimed to determine the effect of interposed abdominal compression (IAC) during resuscitation on outcomes of ED cardiac arrests.
Methods: In this randomized clinical trial study, non-trauma patients aged 18-85 years, patients with in-hospital cardiac arrest hospitalized in the ED were randomly assigned into two either STD-CPR or IAC-CPR group on a 1:1 basis and using computer-generated random numbers. Participants in the intervention group, received abdominal compression during the diastole phase of STD-CPR. The rate of return of spontaneous circulation (ROSC), heart rate (HR), respiratory rate (RR), arterial blood gas (ABG) indicators, and survival rate were compared between the two groups.
Results: Ninety patients were enrolled (45 in each group). There were no differences between the two groups regarding age (p = 0.76), sex (p = 0.39), employment status (p = 0.62) and Charlson comorbidity scale (p = 0.46). Abdominal compression had a positive effect on heart rate (p < 0.001), mean arterial pressure (p = 0.003), arterial blood oxygen pressure (p = 0.001), and arterial blood carbon dioxide pressure (p = 0.001) as well as a negative effect on arterial blood oxygen saturation (p = 0.029) 30 minutes after resuscitation. Out of the 90 CPR cases, 8 (17.7%) cases in intervention group and 8 (17.7%) cases in control group were successful, among which all of the 8 patients in the intervention group and 5 of the patients in the control group had been discharged from hospital without any complications.
Conclusion: The results showed that abdominal compression during CPR can improve resuscitation outcomes in patients with cardiac arrest. Therefore, in order to use this technique, further research is recommended.
- Heart Arrest
- Cardiopulmonary Resuscitation
- Treatment Outcome
- Clinical trial
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参考
Peterson DF, Siebert DM, Kucera KL, Thomas LC, Maleszewski JJ, Lopez-Anderson M, et al. Etiology of sudden cardiac arrest and death in US competitive athletes: a 2-year prospective surveillance study. Clin J Sport Med. 2020;30(4):305-314.
Gräsner J-T, Bossaert L. Epidemiology and management of cardiac arrest: what registries are revealing. Best Pract Res Clin Anaesthesiol. 2013;27(3):293-306.
Holmberg MJ, Ross CE, Fitzmaurice GM, Chan PS, Duval-Arnould J, Grossestreuer AV, et al. Annual incidence of adult and pediatric in-hospital cardiac arrest in the United States.
Circ Cardiovasc Qual Outcomes. 2019;12(7):e005580.
Bhatnagar V, Jinjil K, Dwivedi D, Verma R, Tandon U. Cardiopulmonary resuscitation: unusual techniques for unusual situations.
J Emerg Trauma Shock. 2018;11(1):31-37.
Beckett V, Knight M, Sharpe P. The CAPS Study: incidence, management and outcomes of cardiac arrest in pregnancy in the UK: a prospective, descriptive study. BJOG. 2017;124(9):1374-1381.
Panchal AR, Bartos JA, Cabañas JG, Donnino MW, Drennan IR, Hirsch KG, et al. Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16_Suppl_2):S366-S468.
Merchant RM, Topjian AA, Panchal AR, Cheng A, Aziz K, Berg KM, et al. Part 1: executive summary: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16_Suppl_2):S337-S57.
McClung CD, Anshus AJ. Interposed abdominal compression CPR for an out-of-hospital cardiac arrest victim failing traditional CPR. West J Emerg Med. 2015; 16(5): 690–692.
Li J-k, Wang J, Li T-f. Interposed abdominal compression-cardiopulmonary resuscitation after cardiac surgery. Interact Cardiovasc Thorac Surg. 2014;19(6):985-989.
Movahedi A, Mirhafez SR, Behnam‐Voshani H, Reihani H, Kavosi A, Ferns GA, et al. A Comparison of the Effect of Interposed Abdominal Compression Cardiopulmonary Resuscitation and Standard Cardiopulmonary Resuscitation Methods on End‐tidal CO 2 and the Return of Spontaneous Circulation Following Cardiac Arrest: A Clinical Trial. Acad Emerg Med. 2016;23(4):448-454.
Zhang S, Liu Q, Han S, Zhang Z, Zhang Y, Liu Y, et al. Standard versus abdominal lifting and compression CPR. Evid Based Complement Alternat Med. 2016; 2016: 9416908. 1-8.
Wang J, Wu G, Yang R, Wang Y, Wang S, Li H, et al. Clinical application of cardiopulmonary resuscitation with abdominal lifting and compression in emergency treatment. Zhonghua wei Zhong Bing ji jiu yi xue. 2017;29(3):265-267.
Wang D, Feng X, Han Y. Interposed abdominal pulling-pressing cardiopulmonary resuscitation improve the resuscitation effect for patients with cardiac arrest. Zhonghua wei Zhong Bing ji jiu yi xue. 2018;30(5):466-470.
Babbs CF. Interposed abdominal compression CPR: a comprehensive evidence based review. Resuscitation. 2003;59(1):71-82.
Ralston SH, Babbs CF, Niebauer MJ. Cardiopulmonary resuscitation with interposed abdominal compression in dogs. Anesth Analg. 1982;61(8):645-51.
Zhou M, Ran Q, Liu Y, Li Y, Liu T, Shen H. Effects of sustained abdominal aorta compression on coronary perfusion pressures and restoration of spontaneous circulation during cardiopulmonary resuscitation in swine. Resuscitation. 2011;82(8):1087-1091.
Reynolds JC, Bond MC, Shaikh S. Cardiopulmonary resuscitation update. Emerg Med Clin North Am. 2012;30(1):35-49.
Wang H-Y, Chew G, Kung C, Chung K, Lee W. The use of Charlson comorbidity index for patients revisiting the emergency department within 72 hours. Chang Gung Med J. 2007;30(5):437-444.
Hall JE HM. Guyton and Hall Textbook of Medical Physiology. 14 ed. USA: Elsevier; 2016.
McInnes AD, Sutton RM, Nishisaki A, Niles D, Leffelman J, Boyle L, et al. Ability of code leaders to recall CPR quality errors during the resuscitation of older children and adolescents. Resuscitation. 2012;83(12):1462-1466.
Sack JB, Kesselbrenner MB, Jarrad A. Interposed abdominal compression-cardiopulmonary resuscitation and resuscitation outcome during asystole and electromechanical dissociation. Circulation. 1992;86(6):1692-1700.
Mateer JR, Stueven HA, Thompson BM, Aprahamian C, Darin JC. Pre-hospital IAC-CPR versus standard CPR: paramedic resuscitation of cardiac arrests. Am J Emerg Med. 1985;3(2):143-146.
Gu C, Liu S, Liu K, Xie Y, Wang L. Effects of interposed abdominal pulling-pressing cardiopulmonary resuscitation on hemodynamics and oxygen metabolism in patients with cardiac arrest. Zhonghua wei Zhong Bing ji jiu yi xue. 2019;31(11):1406-1410.
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