Combination of two devices increases long-term survival in cardiac arrest patients

A combination of two devices could save the lives of several thousand cardiac arrest patients each year if implemented nationwide, suggests results of a clinical trial presented at today's American Heart Association Resuscitation Science Symposium. A significantly higher percentage of patients who experienced out-of-hospital cardiac arrest survived after receiving active compression decompression cardiopulmonary resuscitation (ACD CPR) performed with the ResQPump™ and the ResQPOD® impedance threshold device as compared to those receiving conventional, manual CPR performed with a pair of hands. Both devices are manufactured by Advanced Circulatory Systems, Inc. (ACSI) in Roseville, Minn.

Ralph J. Frascone, MD, associate professor of emergency medicine at the University of Minnesota and EMS medical director at Regions Hospital in St. Paul (Minn), presented the results of the study.

"Each year, approximately 300,000 Americans experience out-of-hospital cardiac arrest, and the national average for survival to hospital discharge is dismal – only about 5 percent," Frascone said. "However, in this study, patients who received CPR by rescuers using the device combination had a 53 percent higher survival to hospital discharge rate with favorable neurologic function than those who did not, and, a significant survival benefit was still present one year after the initial cardiac arrest event."

"The goal of resuscitation during cardiac arrest is long-term survival with preservation of brain function," commented Dr. Tom P. Aufderheide, principal investigator at one of the study sites. "This new, effective intervention achieves that goal and is potentially the most significant advancement in the treatment of cardiac arrest since defibrillation."

Funded by the National Institutes of Health and sponsored by Advanced Circulatory Systems, Inc., the trial compared survival rates among a control group of 813 cardiac arrest patients receiving standard CPR to an intervention group of 840 receiving ACD CPR, performed using the ResQPump, with an impedance threshold device (ITD), the ResQPOD. All other aspects of patient care, such as airway management, IV fluids, medications, defibrillation, resuscitation length, etc., were similar between the two groups. The randomized, prospective, multi-center trial was performed in seven distinct U.S. geographic locations, including 46 emergency medical services (EMS) agencies in urban, suburban, and rural areas serving a total population of 2.3 million.

"We are thrilled," said Keith G. Lurie, MD, chief medical officer of Advanced Circulatory Systems. "This was a huge undertaking, involving thousands of EMS providers and hospital personnel over a span of about five years. It is also the first prospective, randomized clinical trial to demonstrate a long-term survival benefit with favorable neurologic benefit using CPR devices."

The ResQPOD® is an impedance threshold device (ITD) that selectively prevents unnecessary respiratory gases from entering the chest during the chest wall recoil phase of CPR. It is attached within the ventilation circuit between the airway device and the ventilation source. By selectively restricting airflow during CPR, the device creates a small but important negative pressure (vacuum) in the chest that has been shown in numerous human and animal clinical trials to increase blood flow back to the patient's heart during CPR.

The ResQPump™ is a hand-held active compression decompression (ACD) CPR device placed in the same position on the sternum as the hands and enabling rescuers to perform similar chest compressions as in conventional CPR. Instead of allowing the chest wall to recoil passively, however, rescuers pull up on the ResQPump's handle with its suction cup. This provides active decompression of the chest, promotes optimal chest wall recoil and creates a negative intrathoracic pressure (vacuum) that helps return blood to the heart. The handle contains a force gauge and metronome that guide compression depth, recoil and rate. The ResQPump is identical to the CardioPump®, an ACD CPR device available for sale outside the U.S.