By Misti Crane
The Columbus Dispatch
COLUMBUS, Ohio — Columbus medics are once again testing a CPR machine in hopes that it can outdo their manual efforts to restart hearts.
Devices that provide automated chest compressions have given hope to doctors and emergency personnel who long to drive up survival rates. But so far, they haven’t been consistently, scientifically proven to out-perform humans in that regard.
Fewer than 5 percent of people who undergo CPR survive, and their chance of living without brain damage is even lower. Columbus medics deal with about 50 cardiac arrests a month, said Capt. Shawn Koser, continuous quality improvement supervisor for the Columbus Fire Division.
For two months, medics from stations 6 and 24 in Columbus will use a device called the Lucas CPR chest-compression system. The Swedish product is sold by a division of Medtronic and costs about $14,500 per machine.
The machines being used here are on loan from the company. If they help outcomes, the city might pursue grants to help it buy machines, Koser said.
European research comparing the device with traditional CPR on patients treated outside the hospital has so far shown no improvement in survival rates, although some studies have found improved circulation and blood pressure.
The ultimate test of any automated CPR machine is whether it keeps more people alive in the long term.
“Theoretically, it should be better” than manual CPR, said Ohio State University’s Dr. Michael Sayre, but the same was thought of AutoPulse, a machine that medics here and in four other cities tested and stopped using in 2005.
Sayre, an emergency physician, led the research in Columbus.
After nine months of study, which included 306 patients here, researchers said they’d found that fewer AutoPulse patients left the hospital alive. Their study and a contradictory study from Virginia appeared in the Journal of the American Medical Association.
The Virginia study showed higher survival rates for those with machine-delivered CPR, leaving researchers in a quandary.
There was speculation that lower survival in the Columbus study might have had more to do with the process of using the automated equipment than the effectiveness of the machine itself.
“We always had a good impression of the device and felt like it did good chest compressions,” Koser said.
The biggest potential benefits are that compressions stay consistent and that it frees medics to help patients in other ways, he said.
“Guys don’t realize it, but they get fatigued,” said Koser, who will review each Columbus case in which the Lucas is used.
The machine is different from the AutoPulse in a couple of ways. First, it delivers 100 compressions a minute at a 2-inch depth, compared to 80 compressions a minute at a 1 1/2 -inch depth, said Linda Gleaves, a sales representative who works with the new product.
It also delivers the compressions through a round device that pushes on the heart rather than a strap that goes around the chest. And it suctions the chest back up after each compression, an action less pronounced on the American machine than on the European one.
It can’t be used on children, pregnant women or trauma patients, Gleaves said.
Sayre said he remains hopeful that automated CPR will give medics a better tool for saving patients, and he would like to see results from a large study of the device on humans. One is under way in Europe.
“The fact is, nine out of 10 sudden-cardiac-arrest patients die. There’s lots of room for improvement,” he said.