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J Korean Soc Emerg Med > Volume 28(6); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(6): 628-634.
병원 전 단계에서 심정지 환자에게 심폐소생술 시 AutoPulseTM 장치를 이용한 흉부 압박과 수기 흉부 압박이 결과에 미치는 영향
박진형1, 조인수1, 김응수2, 하철민1
1한일병원 응급의학과
2한일병원 흉부외과
Comparison of Outcomes between AutoPulseTM and Manual Compression in Out-of-hospital Cardiac Arrest Patient
Jin Hyung Park1, In Soo Cho1, Eung Soo Kim2, Cheol Min Ha1
1Department of Emergency Medicine, Hanil General Hospital, Seoul, Korea
2Department of Cardiothoracic Surgery, Hanil General Hospital, Seoul, Korea
Correspondence  Cheol Min Ha ,Tel: 02-901-3008, Fax: 02-901-3008, Email: sixsigma@naver.com,
Received: June 19, 2017; Revised: June 20, 2017   Accepted: September 4, 2017.  Published online: December 31, 2017.
ABSTRACT
Purpose:
This study compared the outcomes of AutoPulseTM compression with manual compression provided by 119 paramedics in out-of-hospital cardiac arrest patients.
Method:
Between March and December 2016, a total of 221 out-of-hospital cardiac arrest patients were included for analysis. The patients included were categorized as the AutoPulseTM compression group and manual compression group. Patient’s age, sex, pre-hospital intubation, bystander cardiopulmonary resuscitation (CPR), initial cardiac rhythm, time from arrest to CPR and CPR duration were reviewed retrospectively. The initial pH, lactate level, white blood cell (WBC) count, delta neutrophil index (DNI), and targeted temperature management status were collected. As clinical outcomes, the return of spontaneous circulation (ROSC), hospital and intensive care unit (ICU) length of stay, survival rate, and cerebral performance category (CPC) scale at discharge were analyzed.
Results:
The initial rhythm and CPR duration were similar in the two groups. On the other hand, the pre-hospital intubation rate and pre-hospital CPR duration were significantly higher in the AutoPulseTM group than the manual group (32.9% vs. 12.7%, p<0.001; 15.2 vs. 11.9 minutes, p=0.002). The ROSC rate, hospital and ICU length of stay, CPC scale and survival rate at discharge as the clinical outcome were similar in the AutoPulseTM group and manual group. The pH was lower and the lactate level was significantly higher in the AutoPulseTM group than the manual group (6.91 vs. 6.96, p=0.007; 12.8 vs. 11.4 mmol/L, p=0.031), but the WBC and DNI were similar in the two groups.
Conclusion:
The use of AutoPulseTM provided by 119 paramedics in out-of-hospital cardiac arrest patients is not associated with better clinical outcomes.
Key words: Heart arrest, Emergency medical technicians, Cardiopulmonary resuscitation, Compression device
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