Active Compression-Decompression: A New Method of Cardiopulmonary Resuscitation.
Development of the ACD device followed the report of successful cardiac resuscitation using
the plumber's helper (JAMA 264:1661, 1990). The active decompression raises the anterior thorax
and could result in a negative intrathoracic pressure allowing greater venous return. After 1 hour of
standard CPR, 3 of 10 patients randomized to ACD CPR rapidly converted to hemodynamically
stable rhythm following 2 minutes of ACD CPR. There were consistent increases in end-tidal
carbon dioxide concentrations and in systolic blood pressure with the ACD technique, as compared
with standard CPR. End-tidal carbon dioxide concentrations predict the likelihood of resuscitation
from cardiac arrest. The average ET carbon dioxide level was 9 mmHg which was associated with a
28% chance of resuscitation. In this study, ACD CPR resulted in 30% resuscitation. JAMA 267:
2916, June 92.