Hennepin County Medical Center

Study Helps Demonstrate More Efficacious Alternative to CPR

A five-year study testing two active compression-decompression cardiopulmonary resuscitation devices against standard cardiopulmonary resuscitation techniques has found significant improvements in survival rates with good neurological outcomes in cardiac arrest patients.

Published in the Jan. 22, 2011 edition of The Lancet, the study examined 2,470 patients who suffered from cardiac arrest between December 2005 and July 2009. Patients treated with the devices – called the ResQ Pod and ResQ Pump – had a 53% greater rate of survival with good neurological outcome one year after cardiac arrest. These patients had a 9% survival rate with good neurologic outcome, while those treated with standard CPR had only a 5.8% survival rate with good neurological outcome.

“They [The ResQ Pod and ResQ Pump] improve blood flow during CPR and with that improve survival and neurologic quality of survival,” said Dr. Brian Mahoney, Hennepin County Medical Center (HCMC) emergency physician and medical director of HCMC Emergency Medical Services who was principal investigator for the Minneapolis site of the ResQ Trial. Minneapolis, one of seven study sites nationwide, entered the most data with more than 500 cardiac arrest patients.

The study’s control group received standard CPR, while the test group received active compression-decompression cardiopulmonary resuscitation with the ResQ Pump, which upon release applies up to 30 pounds of negative intrathoracic pressure. The ResQ Pod augments the pressure by sealing off the airway while still allowing rescue workers to give breaths to patients.

“We collected the data, but all of the firefighters, paramedics and rescue workers did all the work,” Mahoney said. In Minneapolis, the Minneapolis Fire Department, HCMC paramedics, Hennepin County Medical Center, HCMC EMS Communications and Training, Minneapolis Emergency Communication Center, North Memorial Medical Center paramedics and EMS training, several hospitals and the Institutional Review Boards of these hospitals, and emergency physicians underwent training every 6 months to ensure proper treatment and testing. The ResQ Pump and ResQ Pod were used on alternating weeks.

“I’m just happy the week I went into cardiac arrest was one that was randomized for the ResQ Pod and ResQ Pump to be used,” said Dr. Gregory D. Olsovsky, a cardiac electrophysiologist who went into cardiac arrest during the study. A firefighter witnessed the incident and was able to administer chest compressions until paramedics arrived with the devices.

Within months of going into cardiac arrest, Olsovsky passed his electrophysiology board exams. “My mind is still in tact,” he said. “I thank Hennepin County Medical Center and the study for allowing me the opportunity to do so well in my recovery.” A key finding of the study was that cardiac arrest patients not only had higher rates of survival with use of the ResQ Pod and ResQ Pump, but also had higher rates of good neurological outcome.

While the ResQ Pod is already approved for use in the United States, the ResQPump is not. Commonly used in Europe, data on the ResQ Pump has not been extensive enough to gain approval from the US Food and Drug Administration (FDA). Mahoney hopes the results of this study will earn the ResQ Pump FDA approval.

“If they are approved and widely used, many more thousands of Americans will be surviving with neurological integrity,” Mahoney said. “Many thousands more than are surviving right now from cardiac arrest.”