医学
随机对照试验
心肺复苏术
出院
急诊医学
内科学
复苏
作者
Lars Wik,Jan‐Aage Olsen,David Persse,Fritz Sterz,Michael Lozano,Marc A. Brouwer,Mark Westfall,Chris M. Souders,Reinhard Malzer,P.M. van Grunsven,David T. Travis,Anne Whitehead,Ulrich Herken,E. Brooke Lerner
出处
期刊:Resuscitation
[Elsevier]
日期:2014-03-20
卷期号:85 (6): 741-748
被引量:279
标识
DOI:10.1016/j.resuscitation.2014.03.005
摘要
Abstract
Objective
To compare integrated automated load distributing band CPR (iA-CPR) with high-quality manual CPR (M-CPR) to determine equivalence, superiority, or inferiority in survival to hospital discharge. Methods
Between March 5, 2009 and January 11, 2011 a randomized, unblinded, controlled group sequential trial of adult out-of-hospital cardiac arrests of presumed cardiac origin was conducted at three US and two European sites. After EMS providers initiated manual compressions patients were randomized to receive either iA-CPR or M-CPR. Patient follow-up was until all patients were discharged alive or died. The primary outcome, survival to hospital discharge, was analyzed adjusting for covariates, (age, witnessed arrest, initial cardiac rhythm, enrollment site) and interim analyses. CPR quality and protocol adherence were monitored (CPR fraction) electronically throughout the trial. Results
Of 4753 randomized patients, 522 (11.0%) met post enrollment exclusion criteria. Therefore, 2099 (49.6%) received iA-CPR and 2132 (50.4%) M-CPR. Sustained ROSC (emergency department admittance), 24h survival and hospital discharge (unknown for 12 cases) for iA-CPR compared to M-CPR were 600 (28.6%) vs. 689 (32.3%), 456 (21.8%) vs. 532 (25.0%), 196 (9.4%) vs. 233 (11.0%) patients, respectively. The adjusted odds ratio of survival to hospital discharge for iA-CPR compared to M-CPR, was 1.06 (95% CI 0.83–1.37), meeting the criteria for equivalence. The 20min CPR fraction was 80.4% for iA-CPR and 80.2% for M-CPR. Conclusion
Compared to high-quality M-CPR, iA-CPR resulted in statistically equivalent survival to hospital discharge.
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