EBQ:LINC Trial - Revision history

Ostermayer: Text replacement - "PEA " to "PEA"

2017-03-10T10:00:47Z

Text replacement - "PEA " to "PEA"

← Older revision		Revision as of 10:00, 10 March 2017
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	'''Initial rhythm:'''		'''Initial rhythm:'''
	:V. fib ''29% vs 30%''		:V. fib ''29% vs 30%''
	:PEA ''20% vs 20%''		:[[PEA]]''20% vs 20%''
	:Asystole ''47% vs 46%''		:Asystole ''47% vs 46%''

Ostermayer: Text replacement - "Category:Cards" to "Category:Cardiology"

2016-03-22T13:54:12Z

Text replacement - "Category:Cards" to "Category:Cardiology"

← Older revision		Revision as of 13:54, 22 March 2016
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	[[Category:EBQ]][[Category:EMS]][[Category:~~Cards~~]]		[[Category:EBQ]][[Category:EMS]][[Category:Cardiology]]

Ostermayer: /* Criticisms & Further Discussion */

2014-06-14T04:37:45Z

Criticisms & Further Discussion

← Older revision		Revision as of 04:37, 14 June 2014
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	==Criticisms & Further Discussion==		==Criticisms & Further Discussion==
	*The study is more about comparing a unique algorithm that prioritizes chest compressions over defibrilation and just so happens to use a mechanical compression device		*The study is more about comparing a unique algorithm that prioritizes chest compressions over defibrilation and just so happens to use a mechanical compression device since the LUCAS arm had a different resuscitation protocol with extra shock delivery at 90 seconds.
	*The study is industry sponsored by Physio-Control and Jolife AB with the lead author receiving consulting fees from Physio-Control		*The study is industry sponsored by Physio-Control and Jolife AB with the lead author receiving consulting fees from Physio-Control
	*Inference regarding the use of mechanical vs manual compressions is limited since a different resuscitation algorithm was used for the two arms		*Inference regarding the use of mechanical vs manual compressions is limited since a different resuscitation algorithm was used for the two arms
	*The study suggests equivalence in the two means of resuscitation (mechanical with modified ~~cpr~~ and traditional ~~cpr~~ algorithms)		*The study suggests equivalence in the two means of resuscitation (mechanical with modified CPR and traditional CPR algorithms) and no increase in adverse events
			*The LUCAS group did not seem to offer a manpower advantage or speed advantage since arrival times in the hospital were faster with the standard CPR group.
			*When focusing on patient centered outcomes, no differences were found in survival outcomes.

	==Funding==		==Funding==

Ostermayer: /* Further Reading */

2014-06-14T04:32:08Z

Ostermayer: /* Criticisms */

2014-01-02T21:37:42Z

Criticisms

← Older revision		Revision as of 21:37, 2 January 2014
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	==Criticisms==		==Criticisms & Further Discussion==
	*The study is more about comparing a unique algorithm that prioritizes chest compressions over defibrilation and just so happens to use a mechanical compression device		*The study is more about comparing a unique algorithm that prioritizes chest compressions over defibrilation and just so happens to use a mechanical compression device
	*The study is industry sponsored by Physio-Control and Jolife AB with the lead author receiving consulting fees from Physio-Control		*The study is industry sponsored by Physio-Control and Jolife AB with the lead author receiving consulting fees from Physio-Control
	*Inference regarding the use of mechanical vs manual compressions is limited since a different resuscitation algorithm was used for the two arms		*Inference regarding the use of mechanical vs manual compressions is limited since a different resuscitation algorithm was used for the two arms
			*The study suggests equivalence in the two means of resuscitation (mechanical with modified cpr and traditional cpr algorithms)

	==Funding==		==Funding==

Ostermayer: /* Baseline Patient Characteristics */

2014-01-02T21:35:32Z

Baseline Patient Characteristics

← Older revision		Revision as of 21:35, 2 January 2014
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	''Mechanical vs Manual CPR''		''Mechanical vs Manual CPR''

	'''age:''' 69 vs 69.1		'''age:''' ''69 vs 69.1''

	'''male:''' 67% vs 66%		'''male:''' ''67% vs 66%''

	'''heart disease:''' 65% vs 63%		'''heart disease:''' ''65% vs 63%''

	'''pulmonary disease:''' 64% vs 69%		'''pulmonary disease:''' ''64% vs 69%''

	'''respiratory arrest:''' 59% vs 47%		'''respiratory arrest:''' ''59% vs 47%''

	'''witnessed arrest:''' 66% vs 65%		'''witnessed arrest:''' ''66% vs 65%''

	'''bystander CPR:''' 57% vs 55%		'''bystander CPR:''' ''57% vs 55%''

	'''Initial rhythm:'''		'''Initial rhythm:'''
	:V. fib 29% vs 30%		:V. fib ''29% vs 30%''
	:PEA 20% vs 20%		:PEA ''20% vs 20%''
	:Asystole 47% vs 46%		:Asystole ''47% vs 46%''

	'''Time to ROSC from start of CPR:''' 17min vs 14min		'''Time to ROSC from start of CPR:''' 17min vs 14min

Ostermayer: /* Baseline Patient Characteristics */

2014-01-02T21:34:35Z

Baseline Patient Characteristics

← Older revision		Revision as of 21:34, 2 January 2014
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	==Baseline Patient Characteristics==		==Baseline Patient Characteristics==
	''Mechanical vs Manual CPR''		''Mechanical vs Manual CPR''

	'''age:''' 69 vs 69.1		'''age:''' 69 vs 69.1

	'''male:''' 67% vs 66%		'''male:''' 67% vs 66%

	'''heart disease:''' 65% vs 63%		'''heart disease:''' 65% vs 63%

	'''pulmonary disease:''' 64% vs 69%		'''pulmonary disease:''' 64% vs 69%

	'''respiratory arrest:''' 59% vs 47%		'''respiratory arrest:''' 59% vs 47%

	'''witnessed arrest:''' 66% vs 65%		'''witnessed arrest:''' 66% vs 65%

	'''bystander CPR:''' 57% vs 55%		'''bystander CPR:''' 57% vs 55%

	'''Initial rhythm:'''		'''Initial rhythm:'''
	:V. fib 29% vs 30%		:V. fib 29% vs 30%
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	:Asystole 47% vs 46%		:Asystole 47% vs 46%

	'''Time to ROSC from start of CPR:''' 17min vs 14min		'''Time to ROSC from start of CPR:''' 17min vs 14min


	==Interventions==		==Interventions==

Ostermayer at 21:30, 2 January 2014

2014-01-02T21:30:26Z

← Older revision		Revision as of 21:30, 2 January 2014
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	[[Category:EBQ]]		[[Category:EBQ]][[Category:EMS]][[Category:Cards]]

Ostermayer: /* Background & Major Points */

2014-01-02T21:28:45Z

Background & Major Points

← Older revision		Revision as of 21:28, 2 January 2014
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	*The LUCAS mechanical CPR device has previously been shown to provide enhanced cerebral blood flow and higher end tidal CO<sub>2</sub> although no survival outcomes have been demonstrated from the device's use<ref>Steen S, Liao Q,Pierre L, Paskevicius A, Sjöberg T. Evaluation of LUCAS, a new device for automatic mechanical compression and active decompression resuscitation. Resuscitation. 2002;55(3):285-299.</ref><ref>Rubertsson S, Karlsten R.Increased cortical cerebral blood flow with LUCAS; a new device for mechanical chest compressions compared to standard external compressions during experimental cardiopulmonary resuscitation. Resuscitation. 2005;65(3):357-363.</ref><ref>Axelsson C, Karlsson T,Axelsson AB, Herlitz J. Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) vs manual CPR according to pressure of end tidal carbon dioxide (P(ET)CO2) during CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation. 2009;80(10):1099-1103.</ref>		*The LUCAS mechanical CPR device has previously been shown to provide enhanced cerebral blood flow and higher end tidal CO<sub>2</sub> although no survival outcomes have been demonstrated from the device's use<ref>Steen S, Liao Q,Pierre L, Paskevicius A, Sjöberg T. Evaluation of LUCAS, a new device for automatic mechanical compression and active decompression resuscitation. Resuscitation. 2002;55(3):285-299.</ref><ref>Rubertsson S, Karlsten R.Increased cortical cerebral blood flow with LUCAS; a new device for mechanical chest compressions compared to standard external compressions during experimental cardiopulmonary resuscitation. Resuscitation. 2005;65(3):357-363.</ref><ref>Axelsson C, Karlsson T,Axelsson AB, Herlitz J. Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) vs manual CPR according to pressure of end tidal carbon dioxide (P(ET)CO2) during CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation. 2009;80(10):1099-1103.</ref>

	*Two randomized studies of OHCA failed to find significant differences between manual and mechanical chest compressions using the Lucas device<ref>Axelsson C, Nestin J, Svensson L, Axelsson AB, Herlitz J. Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of out-of-hospital cardiac arrest—a pilot study. Resuscitation. 2006;71(1):47-55.</ref>		*Two randomized studies of OHCA failed to find significant differences between manual and mechanical chest compressions using the Lucas device<ref>Axelsson C, Nestin J, Svensson L, Axelsson AB, Herlitz J. Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of out-of-hospital cardiac arrest—a pilot study. Resuscitation. 2006;71(1):47-55.</ref><ref>Smekal D, Johansson J, Huzevka T, Rubertsson S. A pilot study of mechanical chest compressions with the LUCAS device in cardiopulmonary resuscitation. Resuscitation. 2011;82(6):702-706.</ref>
	<ref>Smekal D, Johansson J, Huzevka T, Rubertsson S. A pilot study of mechanical chest compressions with the LUCAS device in cardiopulmonary resuscitation. Resuscitation. 2011;82(6):702-706.</ref>

	*This study sought to emphasize the benefit of maximizing compression ratio and increasing compressions prior to defibrillation by first responders in cardiac arrest.<ref>Cobb LA, Fahrenbruch CE, Walsh TR, et al. Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation. JAMA. 1999;281(13):1182- 1188.</ref><ref>Wik L, Hansen TB, Fylling F, et al. Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: a randomized trial. JAMA. 2003;289(11):1389-1395.</ref>		*This study sought to emphasize the benefit of maximizing compression ratio and increasing compressions prior to defibrillation by first responders in cardiac arrest.<ref>Cobb LA, Fahrenbruch CE, Walsh TR, et al. Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation. JAMA. 1999;281(13):1182- 1188.</ref><ref>Wik L, Hansen TB, Fylling F, et al. Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: a randomized trial. JAMA. 2003;289(11):1389-1395.</ref>

Ostermayer: references

2014-01-02T21:28:13Z

references

← Older revision		Revision as of 21:28, 2 January 2014
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	==Background & Major Points==		==Background & Major Points==
	*The LUCAS mechanical CPR device has previously been shown to provide enhanced cerebral blood flow and higher end tidal CO<sub>2</sub> although no survival outcomes have been demonstrated from the device's use<ref>Steen S, Liao Q,Pierre L, Paskevicius A, Sjöberg T. Evaluation of LUCAS, a new device for automatic mechanical compression and active decompression resuscitation. Resuscitation. 2002;55(3):285-299.</ref><ref>Rubertsson S, Karlsten R.Increased cortical cerebral blood flow with LUCAS; a new device for mechanical chest compressions compared to standard external compressions during experimental cardiopulmonary resuscitation. Resuscitation. 2005;65(3):357-363.<ref>Axelsson C, Karlsson T,Axelsson AB, Herlitz J. Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) vs manual CPR according to pressure of end tidal carbon dioxide (P(ET)CO2) during CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation. 2009;80(10):1099-1103.</ref>		*The LUCAS mechanical CPR device has previously been shown to provide enhanced cerebral blood flow and higher end tidal CO<sub>2</sub> although no survival outcomes have been demonstrated from the device's use<ref>Steen S, Liao Q,Pierre L, Paskevicius A, Sjöberg T. Evaluation of LUCAS, a new device for automatic mechanical compression and active decompression resuscitation. Resuscitation. 2002;55(3):285-299.</ref><ref>Rubertsson S, Karlsten R.Increased cortical cerebral blood flow with LUCAS; a new device for mechanical chest compressions compared to standard external compressions during experimental cardiopulmonary resuscitation. Resuscitation. 2005;65(3):357-363.</ref><ref>Axelsson C, Karlsson T,Axelsson AB, Herlitz J. Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) vs manual CPR according to pressure of end tidal carbon dioxide (P(ET)CO2) during CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation. 2009;80(10):1099-1103.</ref>

	*Two randomized studies of OHCA failed to find significant differences between manual and mechanical chest compressions using the Lucas device<ref>Axelsson C, Nestin J, Svensson L, Axelsson AB, Herlitz J. Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of out-of-hospital cardiac arrest—a pilot study. Resuscitation. 2006;71(1):47-55.</ref>		*Two randomized studies of OHCA failed to find significant differences between manual and mechanical chest compressions using the Lucas device<ref>Axelsson C, Nestin J, Svensson L, Axelsson AB, Herlitz J. Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of out-of-hospital cardiac arrest—a pilot study. Resuscitation. 2006;71(1):47-55.</ref>

← Older revision		Revision as of 04:32, 14 June 2014
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	==Further Reading==		==Further Reading==
			*EMLit of Note - [http://www.emlitofnote.com/2013/12/man-vs-machine-cpr-battle-to-the.html Man vs Machine]
			*ALiEM - [http://academiclifeinem.com/mechanical-cpr-linc-trial/ Mechanical CPR and LINC trial]
			*ScanCrit - [http://www.scancrit.com/2013/12/03/man-machine-1-1/ CPR Man vs Machine: 1-1]
			*Emergency medicine Ireland - [http://emergencymedicineireland.com/2014/06/linc-trial/ The LINC Trial]

	==References==		==References==