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Nagashima F, Inoue S, Oda T, Hamagami T, Matsuda T, Kobayashi M, Inoue A, Hifumi T, Sakamoto T, Kuroda Y. Optimal chest compression for cardiac arrest until the establishment of ECPR: Secondary analysis of the SAVE-J II study. Am J Emerg Med 2024; 78:102-111. [PMID: 38244243 DOI: 10.1016/j.ajem.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 01/22/2024] Open
Abstract
INTRODUCTION The widespread incorporation of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest requires the delivery of effective and high-quality chest compressions prior to the initiation of ECPR. The aim of this study was to evaluate and compare the effectiveness of mechanical and manual chest compressions until the initiation of ECPR. METHODS This study was a secondary analysis of the Japanese retrospective multicenter registry "Study of Advanced Life Support for Ventricular Fibrillation by Extracorporeal Circulation II (SAVE-J II)". Patients were divided into two groups, one receiving mechanical chest compressions and the other receiving manual chest compressions. The primary outcome measure was mortality at hospital discharge, while the secondary outcome was the cerebral performance category (CPC) score at discharge. RESULTS Of the 2157 patients enrolled in the SAVE-J II trial, 453 patients (329 in the manual compression group and 124 in the mechanical compression group) were included in the final analysis. Univariate analysis showed a significantly higher mortality rate at hospital discharge in the mechanical compression group compared to the manual compression group (odds ratio [95% CI] = 2.32 [1.34-4.02], p = 0.0026). Multivariate analysis showed that mechanical chest compressions were an independent factor associated with increased mortality at hospital discharge (adjusted odds ratio [95% CI] = 2.00 [1.11-3.58], p = 0.02). There was no statistically significant difference in CPC between the two groups. CONCLUSION For patients with out-of-hospital cardiopulmonary arrest who require ECPR, extreme caution should be used when performing mechanical chest compressions.
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Affiliation(s)
- Futoshi Nagashima
- Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital, Hyogo, Japan.
| | | | - Tomohiro Oda
- Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital, Hyogo, Japan.
| | - Tomohiro Hamagami
- Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital, Hyogo, Japan.
| | - Tomoya Matsuda
- Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital, Hyogo, Japan.
| | - Makoto Kobayashi
- Emergency Medical Center, Tottori Prefectural Central Hospital, Tottori, Japan.
| | - Akihiko Inoue
- Hyogo Emergency Medical Center, Department of Emergency and Critical Care Medicine, Hyogo, Japan.
| | - Toru Hifumi
- St. Luke's International Hospital, Department of Emergency and Critical Care Medicine, Tokyo, Japan.
| | - Tetsuya Sakamoto
- Teikyo University School of Medicine, Department of Emergency Medicine, Tokyo, Japan.
| | - Yasuhiro Kuroda
- Kagawa University Hospital, Department of Emergency, Disaster and Critical Care Medicine, Kagawa, Japan.
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Li Y, Li Z, Li C, Cai W, Liu T, Li J, Fan H, Cao C. Out-of-hospital cardiac arrest: A data-driven visualization of collaboration, frontier identification, and future trends. Medicine (Baltimore) 2023; 102:e34783. [PMID: 37603499 PMCID: PMC10443760 DOI: 10.1097/md.0000000000034783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/26/2023] [Indexed: 08/23/2023] Open
Abstract
One of the main causes of death is out-of-hospital cardiac arrest (OHCA), which has a poor prognosis and poor neurological outcomes. This phenomenon has attracted increasing attention. However, there is still no published bibliometric analysis of OHCA. This bibliometric analysis of publications on OHCA aimed to visualize the current status of research, determine the frontiers of research, and identify future trends. Publications on OHCA were downloaded from the web of science database. The data elements included year, countries/territories, institutions, authors, journals, research areas, citations of publications, etc. Joinpoint regression and exponential models were used to identify and predict the trend of publications, respectively. Knowledge domain maps were applied to conduct contribution and collaboration, cooccurrence, cocitation, and coupled analyses. Timeline and burst detection analysis were used to identify the frontiers in the field. A total of 3 219 publications on OHCA were found from 1998 to 2022 (average annual percentage change = 16.7; 95% CI 14.4, 19.1). It was estimated that 859 articles and reviews would be published in 2025. The following research hotpots were identified: statement, epidemiology, clinical care, factors influencing prognosis and emergency medical services. The research frontier identification revealed that 7 categories were classified, including therapeutic hypothermia, emergency medical services, airway management, myocardial infarction, extracorporeal cardiopulmonary resuscitation, stroke foundation and trial. The burst detection analysis revealed that percutaneous coronary intervention, neurologic outcome, COVID-19 and extracorporeal cardiopulmonary resuscitation are issues that should be given continual attention in the future. This bibliometric analysis may reflect the current status and future frontiers of OHCA research.
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Affiliation(s)
- Yue Li
- College of Management and Economics, Tianjin University, Tianjin, China
| | - Zhaoying Li
- Chest hospital, Tianjin University, Tianjin, China
| | - Chunjie Li
- Chest hospital, Tianjin University, Tianjin, China
| | - Wei Cai
- Department of Prevention and Therapy of Cardiovascular Diseases in Alpine Environment of Plateau, Characteristic Medical Center of the Chinese People’s Armed Police Forces, Tianjin, China
| | - Tao Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Ji Li
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Haojun Fan
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
- Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, China
| | - Chunxia Cao
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
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Sun M, Li K, Xu F, Jiang L, Wang J, Xu F, Chen Y. High-Quality Chest Compression for Cardiopulmonary Resuscitation Using Newly-Designed Automatic Device. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38082569 DOI: 10.1109/embc40787.2023.10340167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
High-quality chest compression during cardiopulmonary resuscitation (CPR) can remarkably improve survival rate and reduce the risk of secondary injury. In this study, a newly-designed automatic chest compression device was applied on an animal model and the effects of chest compression were examined in comparison of manual compression and machine compression by a commercialized device. Three pigs (weight:30±2 kg) were used for the experiment. A LUCAS2 CPR machine and the newly-designed CPR device were used for automatic compression treatment. Compression pressure and chest displacement were collected in the process of CPR. Regarding the statistical distribution of compression depths, the new CPR device showed a mean of the depths at 1.64 inches, which was greater than that of manual (mean = 1.21 inches) and of LUCAS2 (mean = 1.18 inches). In addition, the new CPR device showed a standard deviation (SD) of compression depths at 0.07 inches, which was lower than that of manual (SD = 0.15 inches) and of LUCAS2 (SD = 0.25 inches). These results suggested that the new CPR device performed higher compression depths with lower compression variability, indicating enforced compression and better stability. This study provided a preliminarily outcomes validating the new CPR device, which may play a role in high-quality chest compression for the first aid in emergency.Clinical Relevance- This study established an animal model to validate a newly-designed automatic device for CPR. Comparing with manual chest compression and automatic compression using LUCAS2, the new device showed greater compression depths and better stability, which may provide more effective CPR treatment for clinical usage.
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Advanced and Invasive Cardiopulmonary Resuscitation (CPR) Techniques as an Adjunct to Advanced Cardiac Life Support. J Clin Med 2022; 11:jcm11247315. [PMID: 36555932 PMCID: PMC9781548 DOI: 10.3390/jcm11247315] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Despite numerous promising innovations, the chance of survival from sudden cardiac arrest has remained virtually unchanged for decades. Recently, technological advances have been made, user-friendly portable devices have been developed, and advanced invasive procedures have been described that could improve this unsatisfactory situation. METHODS A selective literature search in the core databases with a focus on randomized controlled trials and guidelines. RESULTS Technical aids, such as feedback systems or automated mechanical cardiopulmonary resuscitation (CPR) devices, can improve chest compression quality. The latter, as well as extracorporeal CPR, might serve as a bridge to treatment (with extracorporeal CPR even as a bridge to recovery). Sonography may be used to improve thoracic compressions on the one hand and to rule out potentially reversible causes of cardiac arrest on the other. Resuscitative endovascular balloon occlusion of the aorta might enhance myocardial and cerebral perfusion. Minithoracostomy, pericardiocentesis, or clamshell thoracotomy might resolve reversible causes of cardiac arrest. CONCLUSIONS It is crucial to identify those patients who may benefit from an advanced or invasive procedure and make the decision to implement the intervention in a timely manner. As with all infrequently performed procedures, sound education and regular training are paramount.
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Gao M, Niu H, Yuan S. Comparison between automated cardiopulmonary resuscitation and manual cardiopulmonary resuscitation in the rescue of cardiac and respiratory arrest. Pak J Med Sci 2022; 38:2208-2214. [PMID: 36415278 PMCID: PMC9676588 DOI: 10.12669/pjms.38.8.6598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/08/2022] [Accepted: 09/06/2022] [Indexed: 09/08/2024] Open
Abstract
Objective To compare the efficacy of automated cardiopulmonary resuscitation (A-CPR) and manual cardiopulmonary resuscitation (M-CPR) in the rescue of cardiac and respiratory arrest. Methods A retrospective, single-center observational study was conducted to identify 106 patients by reviewing medical records of 269 patients with cardiac and respiratory arrest treated in The Second Hospital of Hebei Medical University, Shandong Provincial Third Hospital (Jinan, China) from February 2019 to February 2021. Patients were divided into A-CPR group (n = 55) and M-CPR group (n = 51) based on the resuscitation treatment method. The groups were matched for age, gender and the cause of cardiac arrest. Rescue effects, blood gas analysis indicators, respiratory dynamics and condition improvement of the two groups were compared. Results In terms of rescue effects, return of spontaneous circulation (ROSC) rate, successful rate of cardiopulmonary resuscitation (CPR), 24-hour survival rate and survival discharge rate in the A-CPR group were higher than M-CPR group (P<0.05). With respect to blood gas analysis indicators and respiratory dynamics, the partial pressure of carbon dioxide (PaCO2) in the A-CPR group was lower than M-CPR group at 15 and 30 minutes after CPR, while the partial pressure of oxygen (PaO2), blood oxygen saturation (SaO2), end expiratory carbon dioxide (PetCO2), coronary perfusion pressure (CPP) and mean arterial pressure (MAP) in the A-CPR group were higher than M-CPR group (P<0.05). In aspect of condition improvement, spontaneous breathing, heart rate, spontaneous circulation, blood pressure recovery time and CPR time in the A-CPR group were shorter than M-CPR group (P<0.05). Conclusion The application effect of A-CPR in the rescue of cardiac and respiratory arrest, the improvement of blood gas analysis indexes, respiration and condition improvement are more significant than M-CPR.
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Affiliation(s)
- Mengying Gao
- Mengying Gao, Department of Emergency, The Second Hospital of Hebei Medical University, Hebei, China
| | - Huiping Niu
- Huiping Niu, Department of Endoscopy Center, The Second Hospital of Hebei Medical University, Hebei, China
| | - Shuang Yuan
- Shuang Yuan, Department of Intensive Care Unit, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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Gaisendrees C, Gerfer S, Ivanov B, Sabashnikov A, Merkle J, Luehr M, Schlachtenberger G, Walter SG, Eghbalzadeh K, Kuhn E, Djordjevic I, Wahlers T. Outcomes after mechanical versus manual chest compressions in eCPR patients. Expert Rev Med Devices 2021; 18:1023-1028. [PMID: 34424111 DOI: 10.1080/17434440.2021.1970528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Extracorporeal cardiopulmonary resuscitation (eCPR) is an established treatment option for cardiac arrest. Mechanical reanimation devices are increasingly used but have been associated with complications. This study evaluates typical injury patterns and differences after mechanical versus manual chest compressions among patients undergoing eCPR. METHODS From 2016 to 2020, 108 eCPR patients were retrospectively analyzed. Primary endpoints were traumatic, hemorrhagic, or inner organ-related complications, defined as pneumothorax, pulmonary bleeding, major bleeding, gastrointestinal bleeding, gastrointestinal ischemia, cardiac tamponade, aortic dissection, sternal or rib fracture. RESULTS 70 patients were treated with mechanical CPR (mCPR) and 38 with conventional CPR (cCPR). There were more CPR-related injuries in the mCPR group (55% vs. 83%, p = 0.01), CPR duration was longer (cCPR 40 ± 28 min vs. mCPR 69 ± 25 min, p = 0.01). There was no significant difference in mortality between the groups. CONCLUSION Mechanical CPR devices are associated with a higher incidence of traumatic and hemorrhagic injuries in patients undergoing eCPR.
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Affiliation(s)
- Christopher Gaisendrees
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Stephen Gerfer
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Borko Ivanov
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Anton Sabashnikov
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Julia Merkle
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Maximilian Luehr
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Georg Schlachtenberger
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Sebastian G Walter
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Kaveh Eghbalzadeh
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Elmar Kuhn
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Ilija Djordjevic
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, Cologne, Germany
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