Evaluation of an impedance threshold device in patients receiving active compression-decompression cardiopulmonary resuscitation for out of hospital cardiac arrest
Evaluation of an impedance threshold device in patients receiving active compression-decompression cardiopulmonary resuscitation for out of hospital cardiac arrest
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DOI：
10.1016/j.resuscitation.2004.01.032
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发表时间：
2004-06-01
期刊：
影响因子：
6.5
通讯作者：
Payen, D
中科院分区：
文献类型：
--
作者：
Plaisance, P;Lurie, KG;Payen, D
目的：这项多中心临床随机对照前瞻性试验的目的是确定吸气阻抗阈值装置(ITD)与主动按压减压(ACD)心肺复苏(CPR)联合使用是否能提高院外心脏骤停患者的存活率。方法和结果：患者被随机分为假手术组(n=200)和主动阻抗阈值组(n=200)，在主动按压-减压心肺复苏期间接受高级心脏生命支持。本研究的主要终点是24小时存活期。2 4h存活率：假瓣膜为44/2 0 0(2 2%)，活动瓣为32%(/2 0 0)(P=0.0 2)。自发性循环(ROSC)恢复、重症监护病房(ICU)入院和出院率在假瓣膜组分别为77例(39%)、57例(29%)和8例(4%)，而主动瓣膜组分别为96例(48%)、79例(40%)(P=0.02)和10例(5%)(P=0.6)。出院时，主动瓣膜组和假瓣膜组分别有6/10和1/8的幸存者神经功能正常(P=0.1)。结论：院外心脏骤停主动加压减压心肺复苏患者使用阻抗阀可显著提高24小时存活率。(C)2004爱思唯尔爱尔兰有限公司。保留所有权利。
Aims: The purpose of this multicentre clinical randomized controlled blinded prospective trial was to determine whether an inspiratory impedance threshold device (ITD), when used in combination with active compression-decompression (ACD) cardiopulmonary resuscitation (CPR), would improve survival rates in patients with out-of-hospital cardiac arrest. Methods and results: Patients were randomized to receive either a sham (n = 200) or an active impedance threshold device (n = 200) during advanced cardiac life support performed with active compression-decompression cardiopulmonary resuscitation. The primary endpoint of this study was 24 h survival. The 24 h survival rates were 44/200 (22%) with the sham valve and 64/200 (32%) with the active valve (P = 0.02). The number of patients who had a return of spontaneous circulation (ROSC), intensive care unit (ICU) admission, and hospital discharge rates was 77 (39%), 57 (29%), and 8 (4%) in the sham valve group versus 96 (48%) (P = 0.05), 79 (40%) (P = 0.02), and 10 (5%) (P = 0.6) in the active valve group. Six out of ten survivors in the active valve group and 1/8 survivors in the sham group had normal neurological function at hospital discharge (P = 0.1). Conclusion: The use of an impedance valve in patients receiving active compression-decompression cardiopulmonary resuscitation for out-of-hospital cardiac arrest significantly improved 24 h survival rates. (C) 2004 Elsevier Ireland Ltd. All rights reserved.