• Tony Smith.
• St. John Ambulance, Northern Region, and Department of Critical Care Medicine, Auckland Hospital, Auckland, New Zealand.
• Curr Opin Crit Care. 2002 Jun 1;8(3):219-23.

AbstractCardiac arrest survival rates remain low despite increased access to advanced cardiac life support. Survival from cardiac arrest is, at least in part, related to the perfusion pressures and blood flow achieved during cardiopulmonary resuscitation (CPR). A number of alternative CPR devices have been developed that aim to improve the perfusion pressures and/or blood flow achieved during CPR. Active compression-decompression CPR devices are by far the most studied alternative CPR devices, but the results have been inconsistent and conflicting. A number of other devices, including the inspiratory impedance threshold valve, minimally invasive direct cardiac massage, phased chest and abdominal compression-decompression CPR, and vest CPR, are all capable of improving perfusion pressures and/or blood flow compared with standard external chest compressions. However, no convincing human outcome data has been produced yet for any of these devices. Although an interesting area of research, none of the alternative CPR devices convincingly improve long-term patient outcomes.

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