J Korean Soc Emerg Med.  2017 Dec;28(6):628-634. 10.0000/jksem.2017.28.6.628.

Comparison of Outcomes between AutoPulse(TM) and Manual Compression in Out-of-hospital Cardiac Arrest Patient

• Park JH
• Cho IS
• Kim ES
• Ha CM

• KMID: 2403282
• DOI: http://doi.org/10.0000/jksem.2017.28.6.628

Abstract

PURPOSE
This study compared the outcomes of AutoPulseTM compression with manual compression provided by 119 paramedics in out-of-hospital cardiac arrest patients.
METHODS
Between March and December 2016, a total of 221 out-of-hospital cardiac arrest patients were included for analysis. The patients included were categorized as the AutoPulseTM compression group and manual compression group. Patient's age, sex, pre-hospital intubation, bystander cardiopulmonary resuscitation (CPR), initial cardiac rhythm, time from arrest to CPR and CPR duration were reviewed retrospectively. The initial pH, lactate level, white blood cell (WBC) count, delta neutrophil index (DNI), and targeted temperature management status were collected. As clinical outcomes, the return of spontaneous circulation (ROSC), hospital and intensive care unit (ICU) length of stay, survival rate, and cerebral performance category (CPC) scale at discharge were analyzed.
RESULTS
The initial rhythm and CPR duration were similar in the two groups. On the other hand, the pre-hospital intubation rate and pre-hospital CPR duration were significantly higher in the AutoPulseTM group than the manual group (32.9% vs. 12.7%, p < 0.001; 15.2 vs. 11.9 minutes, p=0.002). The ROSC rate, hospital and ICU length of stay, CPC scale and survival rate at discharge as the clinical outcome were similar in the AutoPulseTM group and manual group. The pH was lower and the lactate level was significantly higher in the AutoPulseTM group than the manual group (6.91 vs. 6.96, p=0.007; 12.8 vs. 11.4 mmol/L, p=0.031), but the WBC and DNI were similar in the two groups.
CONCLUSION
The use of AutoPulseTM provided by 119 paramedics in out-of-hospital cardiac arrest patients is not associated with better clinical outcomes.

Keyword

Heart arrest; Emergency medical technicians; Cardiopulmonary resuscitation; Compression device

MeSH Terms

Allied Health Personnel
Cardiopulmonary Resuscitation
Emergency Medical Technicians
Hand
Heart Arrest
Humans
Hydrogen-Ion Concentration
Intensive Care Units
Intubation
Lactic Acid
Length of Stay
Leukocytes
Neutrophils
Out-of-Hospital Cardiac Arrest*
Retrospective Studies
Survival Rate
Lactic Acid