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(Circulation. 2005;112:IV-47 – IV-50.)
© 2005 American Heart Association, Inc.

2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Part 6: CPR Techniques and Devices

	Introduction

 
Over the past 25 years a variety of alternatives to standard manual CPR have been developed in an effort to improve ventilation or perfusion during cardiac arrest and ultimately to improve survival. Compared with standard CPR, these techniques and devices typically require more personnel, training, or equipment, or they apply to a specific setting. Maximum benefits are reported when adjuncts are begun early in the treatment of cardiac arrest, so that the use of these alternatives to CPR is often limited to the hospital setting. To date no adjunct has consistently been shown to be superior to standard manual CPR for out-of-hospital basic life support, and no device other than a defibrillator has consistently improved long-term survival from out-of-hospital cardiac arrest. The data reported here is limited to clinical trials, so most animal data is excluded from this section.

	CPR Techniques

 
High-Frequency Chest Compressions
High-frequency (>100 per minute) manual or mechanical chest compressions have been studied as a technique for improving resuscitation from cardiac arrest.^1–4 The sparse animal and human data available show mixed results. One clinical trial of 9 patients showed that high-frequency (120 per minute) chest compressions improved hemodynamics over standard CPR (LOE 4).⁵ The use of high-frequency chest compressions for cardiac arrest by adequately trained rescue personnel can be considered, but there is insufficient evidence to recommend for or against its use (Class Indeterminate).

Open-Chest CPR
No prospective randomized studies of open-chest CPR for resuscitation have been published. Four relevant human studies were reviewed: 2 were performed to treat in-hospital cardiac arrest following cardiac . . . [Full Text of this Article]