Skip to main content
SpringerLink
Log in

Effect of the AutoPulse™ automated band chest compression device on hemodynamics in out-of-hospital cardiac arrest resuscitation

  • Brief Report
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Purpose

Guidelines for advanced life support of cardiac arrest (CA) emphasize continuous and effective chest compressions as one of the main factors of cardiopulmonary resuscitation (CPR) success. The use of an automated load distributing chest compression device for CPR is promising but initial studies on survival show contradictory results. The aim of this study was to evaluate the effects of AutoPulse™ on blood pressure (BP) in out-of-hospital CA patients.

Methods

This prospective study included adult patients presenting with in refractory out-of-hospital CA. Invasive arterial BP produced by AutoPulse™ was compared to BP generated by manual CPR (Active Compression Decompression). Systolic, diastolic and mean BP and end-tidal carbon dioxide were recorded before and after initiating the automated band device for each patient. The comparison of diastolic BP produced by manual CPR versus automated chest compressions was the primary end point.

Results

Hemodynamics in 29 patients are reported and analyzed. Median diastolic BP increased after starting AutoPulse™ from 17[11–25] mmHg to 23[18–28] mmHg (P < 0.001). Median systolic BP increased from 72[55–105] mmHg to 106[78–135] mmHg (P = 0.02). Mean BP increased from 29[25–38] mmHg to 36[30–15] mmHg (P = 0.002). On the other hand, End-Tidal CO2 did not increase significantly with AutoPulse™ (21[13–36] vs. 22[12–35] mmHg, P = 0.80).

Conclusions

In patients with out-of-hospital CA, the use of AutoPulse™ is associated with an increased diastolic BP compared to manual chest compressions. While its benefit to survival has yet to be demonstrated, the increase in diastolic and mean BP is a promising outcome for AutoPulse™ use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Nolan JP, Deakin CD, Soar J, Böttiger BW, Smith G (2005) European resuscitation council guidelines for resuscitation 2005, Section 4. Adult advanced life support. Resuscitation 67(Suppl 1):S39–S86

    Article  PubMed  Google Scholar 

  2. International Liaison Committee on Resuscitation (2005) 2005 International guidelines conference on cardiopulmonary resuscitation and emergency care science with treatment recommendations. Part 4: advanced life support. Resuscitation 67:213–247

    Article  Google Scholar 

  3. Delguercio LR, Feins NR, Cohn JD, Coomaraswamy RP, Wollman SB, State D (1965) Comparison of blood flow during external and internal cardiac massage in man. Circulation 31:171–180

    PubMed  Google Scholar 

  4. Morley PT (2007) Improved cardiac arrest outcomes: as time goes by? Crit Care 11:130

    Article  PubMed  Google Scholar 

  5. Wik L, Kramer-Johansen J, Myklebust H, Sørebø H, Svensson L, Fellows B, Steen PA (2005) Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA 293:299–304

    Article  CAS  PubMed  Google Scholar 

  6. Ochoa FJ, Ramalle-Gomara E, Lisa V, Saralegui I (1998) The effect of rescuer fatigue on the quality of chest compressions. Resuscitation 37:149–152

    Article  CAS  PubMed  Google Scholar 

  7. Halperin HR, Paradis N, Ornato JP, Zviman M, Lacorte J, Lardo A, Kern KB (2004) Cardiopulmonary resuscitation with a novel chest compression device in a porcine model of cardiac arrest: improved hemodynamics and mechanisms. J Am Coll Cardiol 44:2212–2214

    Article  Google Scholar 

  8. Timerman S, Cardoso LF, Ramires JA, Haleprin H (2004) Improved hemodynamic performance with a novel chest compression device during treatment of in-hospital cardiac arrest. Resuscitation 61:273–280

    Article  PubMed  Google Scholar 

  9. Ong ME, Ornato JP, Edwards DP, Dhindsa HS, Best AM, Ines CS, Hickey S, Clark B, Williams DC, Powell RG, Overton JL, Peberdy MA (2006) Use of an automated, load-distributing band chest compression device for out-of-hospital cardiac arrest resuscitation. JAMA 295:2629–2637

    Article  CAS  PubMed  Google Scholar 

  10. Hallstrom A, Rea TD, Sayre MR, Christenson J, Anton AR, Mosesso VN Jr, Van Ottingham L, Olsufka M, Pennington S, White LJ, Yahn S, Husar J, Morris MF, Cobb LA (2006) Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial. JAMA 295:2620–2628

    Article  CAS  PubMed  Google Scholar 

  11. Gueugniaud PY, David JS, Chanzy E, Hubert H, Dubien PY, Mauriaucourt P, Bragança C, Billères X, Clotteau-Lambert MP, Fuster P, Thiercelin D, Debaty G, Ricard-Hibon A, Roux P, Espesson C, Querellou E, Ducros L, Ecollan P, Halbout L, Savary D, Guillaumée F, Maupoint R, Capelle P, Bracq C, Dreyfus P, Nouguier P, Gache A, Meurisse C, Boulanger B, Lae C, Metzger J, Raphael V, Beruben A, Wenzel V, Guinhouya C, Vilhelm C, Marret E (2006) Vasopressin and epinephrine vs. epinephrine alone in cardiopulmonary resuscitation. N Engl J Med 359:21–30

    Article  Google Scholar 

  12. Krep H, Marnier M, Breil M, Heister U, Fischer M, Hoeft A (2007) Out-of-hospital cardiopulmonary resuscitation with Autopulse system: a prospective observational study with a new load-distributing band chest compression device. Resuscitation 73:86–95

    Article  PubMed  Google Scholar 

  13. Plaisance P, Lurie KG, Vicaut E, Adnet F, Petit JL, Epain D, Ecollan P, Gruat R, Cavagna P, Biens J, Payen D (1999) A comparison of standard cardiopulmonary resuscitation and active compression–decompression resuscitation for out-of-hospital cardiac arrest. French active compression-decompression cardiopulmonary resuscitation study group. N Engl J Med 31:569–575

    Article  Google Scholar 

  14. Duchateau FX, Ricard-Hibon A, Chollet C, Belpomme V, BenHellal A, Marty J (2003) Feasibility of intra-arterial blood pressure monitoring in prehospital care. JEUR 16:123–126

    Google Scholar 

  15. Cantineau JP, Lambert Y, Merckx P, Reynaud P, Porte F, Bertrand C, Duvaldestin P (1996) End-tidal carbon dioxide during cardiopulmonary resuscitation in humans presenting mostly with asystole: a predictor of outcome. Crit Care Med 24:791–796

    Article  CAS  PubMed  Google Scholar 

  16. Ducros L, Vicaut E, Soleil C, Lurie KG, Plaisance P, Payen D (2010) Effect of the addition of vasopressin, or vasopressin plus nitroglycerine to epinephrine on arterial blood pressure during cardiopulmonary resuscitation in human. J Emerg Med (in press)

  17. Ewy GA, Zuercher M, Hilwig RW, Sanders AB, Berg RA, Otto CW, Hayes MM, Kern KB (2007) Improved neurological outcome with continuous chest compressions compared with 30:2 compressions-to-ventilations cardiopulmonary resuscitation in a realistic swine model of out-of-hospital cardiac arrest. Circulation 116:2525–2530

    Article  PubMed  Google Scholar 

  18. Kern KB, Ewy GA, Voorhees WD, Babbs CF, Tacker WA (1988) Myocardial perfusion pressure: a predictor of 24-hour survival during prolonged cardiac arrest in dogs. Resuscitation 16:241–250

    Article  CAS  PubMed  Google Scholar 

  19. Idris AH, Straples E, O’Brian DJ, Melker RJ, Del Duca KD, Falk JL (1994) The effect of ventilation on acid-base balance and oxygenation in low blood-flow states. Crit Care Med 22:1827–1834

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to acknowledge Bernard Cholley, MD, PhD, for his technical help in interpreting the data and the French Society of Emergency Medicine fellowship for funding.

Conflict of interest statement

None of the authors has a potential conflict of interest.

Author information

Authors and Affiliations

  1. Department of Anaesthesiology and Intensive Care, Beaujon University Hospital, 100 bd du Général Leclerc, 92110, Clichy, France

    François-Xavier Duchateau, Sonja Curac, Jean Mantz & Agnès Ricard-Hibon

  2. Department of Anesthesiology and Critical Care, Lariboisiere University Hospital, Paris, France

    Papa Gueye, Claire Broche & Didier Payen

  3. Emergency Department, Lariboisiere University Hospital, Paris, France

    Patrick Plaisance

  4. Clinical Research Unit, Bichat-Claude Bernard University Hospital, Paris, France

    Florence Tubach

Authors
  1. François-Xavier Duchateau
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Papa Gueye
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sonja Curac
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Florence Tubach
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Claire Broche
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Patrick Plaisance
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Didier Payen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jean Mantz
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Agnès Ricard-Hibon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to François-Xavier Duchateau.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duchateau, FX., Gueye, P., Curac, S. et al. Effect of the AutoPulse™ automated band chest compression device on hemodynamics in out-of-hospital cardiac arrest resuscitation. Intensive Care Med 36, 1256–1260 (2010). https://doi.org/10.1007/s00134-010-1784-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-010-1784-x

Keywords

Search

Navigation