No clear benefit from active chest compression-decompression compared with standard manual CPR

Clinical question: 
How effective is active chest compression-decompression cardiopulmonary resuscitation (ACDR CPR) in adults with cardiac arrest?
Bottom line: 
There was no clear evidence of benefits from the use of ACDR CPR compared with standard manual CPR in people with cardiac arrest occurring in different settings and different emergency medical systems. There were no differences between ACDR CPR and standard manual CPR for mortality (immediate or at hospital discharge), severity of neurological impairment or complications, such as rib or sternal fracture, pneumothorax or haemothorax. Skin trauma and ecchymosis were more frequent with ACDR CPR.
Caveat: 
Eight studies were in out-of-hospital settings, one was set in-hospital only and one had both in-hospital and out-ofhospital components. Assessment of neurological outcomes was limited, and few participants had neurological damage
Context: 
During standard CPR for cardiac arrest, the chest is compressed manually and repeatedly by hand. During standard CPR the chest is not manually decompressed. ACDR CPR uses a hand-held suction device, applied midsternum, to compress the chest then actively decompress the chest after each compression.
Review CD#: 
CD002751
PEARLS No: 
409
Date: 
October, 2013
Authored by: 
Brian R McAvoy