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Mechanical chest co...
Mechanical chest compressions and simultanous defibrillationvs conventional cardiopulmonary resuscitationin out-of hospital cardiac arrest:the LINC randomized trial
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- Rubertsson, Sten (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Lindgren, Erik (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Smekal, David (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Östlund, Ollie (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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Silverstolpe, Johan (author)
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Lichtveld, Robert A (author)
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Boomars, Rene (author)
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Ahlstedt, Björn (author)
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Skoog, Gunnar (author)
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Kastberg, Robert (author)
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Halliwell, David (author)
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Box, Martyn (author)
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- Herlitz, Johan (author)
- Högskolan i Borås,Institutionen för Vårdvetenskap,Prehospital akutsjukvård
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- Karlsten, Rolf (author)
- Uppsala universitet,Anestesiologi och intensivvård
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Smekal, E (author)
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Skoog, B (author)
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(creator_code:org_t)
- American Medical Association, 2014
- 2014
- English.
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In: Journal of the American Medical Association (JAMA). - : American Medical Association. - 0098-7484 .- 1538-3598. ; 311:1, s. 53-61
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https://doi.org/10.1...
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Abstract
Subject headings
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- IMPORTANCE: A strategy using mechanical chest compressions might improve the poor outcome in out-of-hospital cardiac arrest, but such a strategy has not been tested in large clinical trials. OBJECTIVE: To determine whether administering mechanical chest compressions with defibrillation during ongoing compressions (mechanical CPR), compared with manual cardiopulmonary resuscitation (manual CPR), according to guidelines, would improve 4-hour survival. DESIGN, SETTING, AND PARTICIPANTS: Multicenter randomized clinical trial of 2589 patients with out-of-hospital cardiac arrest conducted between January 2008 and February 2013 in 4 Swedish, 1 British, and 1 Dutch ambulance services and their referring hospitals. Duration of follow-up was 6 months. INTERVENTIONS: Patients were randomized to receive either mechanical chest compressions (LUCAS Chest Compression System, Physio-Control/Jolife AB) combined with defibrillation during ongoing compressions (n = 1300) or to manual CPR according to guidelines (n = 1289). MAIN OUTCOMES AND MEASURES: Four-hour survival, with secondary end points of survival up to 6 months with good neurological outcome using the Cerebral Performance Category (CPC) score. A CPC score of 1 or 2 was classified as a good outcome. RESULTS: Four-hour survival was achieved in 307 patients (23.6%) with mechanical CPR and 305 (23.7%) with manual CPR (risk difference, -0.05%; 95% CI, -3.3% to 3.2%; P > .99). Survival with a CPC score of 1 or 2 occurred in 98 (7.5%) vs 82 (6.4%) (risk difference, 1.18%; 95% CI, -0.78% to 3.1%) at intensive care unit discharge, in 108 (8.3%) vs 100 (7.8%) (risk difference, 0.55%; 95% CI, -1.5% to 2.6%) at hospital discharge, in 105 (8.1%) vs 94 (7.3%) (risk difference, 0.78%; 95% CI, -1.3% to 2.8%) at 1 month, and in 110 (8.5%) vs 98 (7.6%) (risk difference, 0.86%; 95% CI, -1.2% to 3.0%) at 6 months with mechanical CPR and manual CPR, respectively. Among patients surviving at 6 months, 99% in the mechanical CPR group and 94% in the manual CPR group had CPC scores of 1 or 2. CONCLUSIONS AND RELEVANCE: Among adults with out-of-hospital cardiac arrest, there was no significant difference in 4-hour survival between patients treated with the mechanical CPR algorithm or those treated with guideline-adherent manual CPR. The vast majority of survivors in both groups had good neurological outcomes by 6 months. In clinical practice, mechanical CPR using the presented algorithm did not result in improved effectiveness compared with manual CPR. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00609778.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)
Keyword
- Prehospital akutsjukvård
- Integrated Caring Science
- Integrerad vårdutveckling
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Rubertsson, Sten
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Lindgren, Erik
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Smekal, David
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Östlund, Ollie
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Silverstolpe, Jo ...
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Lichtveld, Rober ...
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show more...
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Boomars, Rene
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Ahlstedt, Björn
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Skoog, Gunnar
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Kastberg, Robert
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Halliwell, David
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Box, Martyn
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Herlitz, Johan
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Karlsten, Rolf
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Smekal, E
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Skoog, B
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Nursing
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Dermatology and ...
- Articles in the publication
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Journal of the A ...
- By the university
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University of Borås
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Uppsala University