AMSTERDAM – LUCAS, a mechanical chest compression device, could be as effective as manual chest compressions, based on results from a multicenter, randomized controlled trial of 5,000 cardiac arrest patients.
The LINC (LUCAS in Cardiac Arrest) study showed that the device was no better than manual chest compression at improving the 4-hour survivals of cardiac arrest patients. Patients exposed to the device were not harmed, however, and their 6-month survival rates and neurologic outcomes were similar to those of patients who received manual compressions, said Dr. Sten Rubertsson, the principle investigator of the study and a consultant for the device’s manufacturer, Physio-Control.
One of several mechanical chest compression devices available in the market, LUCAS has a piston and suction cup mechanism that performs chest compressions at guideline recommended rates. The device also permits simultaneous use of a defibrillator.
In a study was conducted between 2008 and 2013, about 2,600 of 5,000 cardiac arrest patients were randomized to either LUCAS or manual compression. The other patients were excluded from the study because they had traumatic cardiac arrest, were pregnant, were defibrillated before LUCAS was on scene, or had a return of spontaneous circulation.
Patients were on average 69 years old and most were men.
The primary endpoint of the study, 4-hour survival, was comparable for both groups at 23.6% for LUCAS and 23.7% for manual compressions.
The study’s secondary endpoint – survival up to 6 months with good neurologic outcome – similarly was comparable at 8.5% for LUCAS and 7.6% for manual compressions.
Conducting a study for several years in a pre-hospital setting is rather difficult, said Dr. Patrick Goldstein of Lille University Hospital France, who commented on the study at the meeting. The results of the trial could be considered neutral, but "I think it is positive for many reasons."
Mechanical chest compressions can be useful in several subgroups, including those patients who need long-term CPR and for those in the non–heart-beating donors programs, for example.
Dr. Rubertsson said that in the future, the device could be used to individualize care, by considering the compressions and EKG, and deciding when to do the interventions.
The LINC study was initiated by Uppsala (Sweden) University and sponsored by Physio-Control/Jolife AB. Dr. Rubertsson has received consultation fee from Physio-Control/Jolife AB. Dr. Goldstein had no relevant conflicts of interest.
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