Manual vs device-assisted CPR
Reconciling apparently contradictory resultsIn an editorial in the June 14th edition of JAMA, Roger J. Lewis, M.D. and James T. Niemann, M.D., investigators at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed), attempt to reconcile apparent contradictions in conclusions drawn from two studies examining use of a mechanical CPR device for the resuscitation patients with out-of-hospital sudden cardiac arrest. One study concluded the device was beneficial, while the other concluded it may be harmful.
Lewis and Niemann deal with several questions raised by the research, including whether the true effectiveness of the device was different in the two settings, whether there was some methodological weakness in the design of the studies and whether anomalous outcome patterns occurred by chance.
The editorial concludes that the degree of benefit or harm associated with use of the LBD-CPR device is influenced by the details of its use – perhaps including selection of the patient population with respect to presenting rhythm, time from cardiac arrest to initiation of CPR, time-to-deployment of the device, and the influence of deployment on time-to-defibrillation.
Out-of-hospital sudden cardiac arrest continues to be a major health problems, resulting in more than 1,000 deaths each day in the United States.
The Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) is one of the largest independent, not-for-profit biomedical research institutes in Los Angeles County. Affiliated with both the David Geffen School of Medicine at UCLA and the Harbor-UCLA Medical Center, the Institute has an annual budget of over $72 million and currently supports more than 1,000 research studies in areas such as cardiology, emerging infections, cancer, dermatology, women's health, reproductive health, vaccine research, respiratory physiology, neonatology, molecular biology, and genetics.
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