Comparison of cardiopulmonary resuscitation by bending and pressing the lower extremities with standard cardiopulmonary resuscitation: a prospective multicenter trial / 中华危重病急救医学

ABSTRACT

Objective To compare the effects of cardiopulmonary resuscitation by bending and pressing the lower extremities (BPLE-CPR) with standard cardiopulmonary resuscitation (S-CPR). Methods A multicenter prospective nonrandomized controlled study was performed. Patients with cardiac arrest (CA) treated in the emergency departments and intensive care units (ICU) of seven hospitals in Eastern China from January 2013 to February 2017 were enrolled. BPLE-CPR or S-CPR was used for resuscitation according to the patient's condition. Data registration was completed in Utstein style. The primary outcome was recovery of spontaneous circulation (ROSC) rate, and the secondary outcome included survival rate at discharge, the resuscitation time of ROSE patients, blood pressures during resuscitation, the survival rates within 24 hours and beyond 24 hours, and the cerebral performance categories (CPC) of discharged patients. Results A total of 279 patients completed data registration, including 142 in the BPLE-CPR group and 137 in the S-CPR group. ROSC rate, survival rates over 24 hours and at discharge in BPLE-CPR group were significantly higher than those in S-CPR group [ROSC rate 63.4% (90/142) vs. 29.2% (40/137), survival rate over 24 hours 56.7% (51/90) vs. 45.0% (18/40), survival rate at discharge 43.0% (61/142) vs. 20.4% (28/137), all P < 0.01]. The CPR duration of ROSC patients in BPLE-CPR group was significantly shorter than that in S-CPR group [minute10 (5, 15) vs. 20 (11, 30), P < 0.01], while systolic blood pressure during CPR was significantly higher than that in S-CPR group [mmHg (1 mmHg = 0.133 kPa) 92.0 (80.0, 110.0) vs. 73.5 (65.5, 80.0), P < 0.01]. In survival discharged patients, the proportion of CPC 1 patients in BPLE-CPR group was significantly higher than that in S-CPR group [24.6% (15/61) vs. 10.7% (3/28), P < 0.01]. Conclusion BPLE-CPR is superior to S-CPR in terms of ROSC rate and discharge survival rate. In addition, the BPLE-CPR procedure is simple and easy to expand in public. Clinical Test Registration Chinese Clinical Trial Registry, ChiCTR-TRC-13003150.