Abstract 100: Comparison of Load Distributing Band and Standard Cardiopulmonary Resuscitation in Patients Presenting With Cardiac Arrest to Emergency Department: a Phased Non Randomised Study Using Historical Controls
Objective: To compare resuscitation outcomes before and after switching from manual cardiopulmonary resuscitation (CPR) to load-distributing band (LDB) CPR in a multi-center Emergency Departments (ED) trial.
Methods: This is a phased, prospective cohort evaluation with intention-to-treat analysis of adults with non-traumatic cardiac arrest. The intervention is change in the system from manual CPR to LDB-CPR at two Urban EDs. The main outcome measure is survival to hospital discharge, with secondary outcome measures of return of spontaneous circulation (ROSC), survival to hospital admission and neurological outcome at discharge.
Results: A total of 1,011 patients were included in the study, with 459 in the manual CPR phase and 552 patients in the LDB-CPR phase. In the LDB phase, the LDB device was applied in 454 patients (82.3%). Patients in the manual CPR and LDB-CPR phases were comparable for mean age, gender and ethnicity. Rates for ROSC were comparable with LDB-CPR (manual 22.4% vs LDB 35.3% adjusted odds ratio [OR], 1.07; 95% CI, 0.63–1.83). Survival to hospital discharge was increased Manual 1.3% vs LDB 3.3% adjusted OR, 3.99; 95% CI, 1.06–15.02. The number of survivors with Cerebral Performance Category 1(good) (Manual 1 vs LDB 12, p<0.01) and Overall Performance Category 1 (good) (Manual 1 vs LDB 10, p<0.01) was also increased. The Number Needed to Treat (NNT) for 1 survivor was 52 (95% CI 26, 1000).
Conclusions: A resuscitation strategy using LDB-CPR in an ED environment was associated with improved survival to admission and discharge in adults with non-traumatic cardiac arrest.
- © 2010 by American Heart Association, Inc.