RE: Dr. Bledsoe - Autopulse

February 20, 2006

Might want to talk to Dr. Y, Hurst FD has them and from what I understand

have a pretty high save rate.

Lee

Dr. Bledsoe - Autopulse

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

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