Abstract 1813: Early Survival After Cardiac Arrest In A Pilot Study Using The LUCAS Device Compared To Manual Chest Compressions During CPR
Introduction: Mechanical chest compressions with the LUCAS device have in experimental studies shown improved organ perfusion but have to be evaluated in prospective studies when applied within time for possible survival.
Hypothesis: We hypothesized that out-of-hospital cardiac arrest (CA) patients treated with mechanical chest compressions using the LUCAS device during CPR in a first tiered ambulance system, would improve early survival as compared to standard advanced cardiac life support (ACLS).
Methods: In a prospective pilot study, from February 1, 2005, to April 1, 2007, 149 patients with out-of hospital CA in two Swedish cities were randomized to either CPR with mechanical chest compressions using the LUCAS device or standard ACLS using manual chest compressions. After inclusion, manual chest compressions were delivered until the device was applied in the LUCAS group. Two ambulances, equipped with LUCAS were discharged simultaneously to the address of the CA victim.
Results: The protocol was fulfilled in 138 patients with 69 patients in each group and no differences in age, gender, arrest being witnessed or proportion of bystander CPR. The first registered ECG was asystole or PEA in 50 vs 47 patients in the LUCAS and manual group respectively and 18 patients having VF in each group. Mean time from alarm to start of CPR was 8.4 min in the LUCAS group vs 7.5 min in the manual (p= 0.29). Time to apply the LUCAS in the LUCAS group was on average 2 min from start of CPR. Restoration of spontaneous pulse was achieved in 30 vs 22 patients (p=0.22), patients hospitalized alive > 4 hrs was 18 vs 15 (p=0.69) and discharged alive 6 vs 7 in the LUCAS and manual group respectively. In a subgroup of patients from the major recruiting city, with witnessed CA and CPR started within 15 min from the alarm (n= 39 manual vs 34 Lucas group), restoration of spontaneous pulse was achieved in 19 vs 13 patients (p=0.06), patients hospitalized alive > 4 hrs in 14 vs 7 (p=0.039) and discharged alive in 5 vs 4 patients in the LUCAS and manual group respectively.
Conclusion: In this pilot study, there was a trend to improved early survival when mechanical chest compressions with the LUCAS device were used during CPR. These findings are promising and will be used for power analysis in a prospective multicenter trial.