Clinical outcomes

LUCAS CPR creates a platform for maintaining blood circulation as well
as a stronger and safer chain of survival

LUCAS ensures that compressions are given with correct frequency and depth, with equal compression and decompression time, and allowing for full recoil of the chest between each compression – without loss of quality over time. These are parameters that research has found crucial for creating good blood circulation and increasing survival in cardiac arrest patients. Furthermore, LUCAS enables defibrillation and angiography to take place without interrupting compressions.

Several publications (see below and menus on the left) show that LUCAS has improved the care of cardiac arrest patients and the working environment for the personnel – in a practical and clinical setting. Currently a randomized multicenter study, the LINC study (Lucas IN Cardiac arrest) is ongoing in Europe headed by Professor Sten Rubertsson in Uppsala, Sweden. 2500 pre-hospital cardiac arrest patients are randomized to LUCAS CPR or manual CPR to further study the efficacy of LUCAS. Study recruitment is expected to close in 2011.

LUCAS CPR in Lund, Sweden: More cardiac arrest patients survive with
good neurological outcome

LUCAS is sometimes referred to as the “Lund University Cardiac Assist System” and indeed has a history of good clinical cooperation with the Lund University Hospital, adjacent hospitals as well as the KAMBER ambulance organisation, all in the Skåne region of southern Sweden.

First introduced in Lund in 2002, the LUCAS device was implemented over the following years in all ambulances and hospitals in the region. This has strengthened the chain of survival in cardiac arrest. In recent years Lund has attained top scores for 1-month survival after cardiac arrest outside hospitals, as reported in the Swedish National Registry for Sudden Cardiac Arrest which is published by Professor J. Herlitz. With LUCAS as a tool for maintaining good blood circulation and safer transportation, the ambulances have delivered twice as many patients to emergency room in Lund. The hospital, where therapeutic cooling after cardiac arrest was implemented simultaneously with LUCAS, has discharged twice as many survivors with better neurological recovery than earlier.

For an overview of the improved results, please review the summary below. By courtesy of H. Olson, Lund, Sweden.

Olson OHCA and outcome 2008 p-ERC.pdf

More references from Lund:

Olson H, Rundgren M, Silverstolpe J, Friberg H. “Out-of-hospital cardiac arrest—–A panorama in transformation” ERC congress 2008; Poster 027 (on file at Jolife) and Resuscitation. 2008; 77S:S47: AP-027.

Olsson P, Steen S, Kongstad P, Sjoberg T. “The outcome of cardiac arrest the years before and after introduction of LUCAS in the ambulances” Resuscitation. 2008; 77S:S9: AS-023

Wagner H, Van der Pals, Olsson H R, Gotberg M, Harnek J, Olivecrona G. “Mechanical chest compression devices can save lives in the cath lab”. Resuscitation. 2008; 77S: S12, AS-031

Steen S, Sjöberg T, Olsson P, Young M. “Treatment of out-of-hospital cardiac arrest with LUCAS, a new device for automatic mechanical compressions and active decompression resuscitation.” Resuscitation. 2005; 67: 25-30

Pubmed abstract; Steen et al; Resuscitation 2005; 67:25-30

Twice as many patients achieved ROSC when LUCAS was implemented in the
chain of survival at Brugmann University Hospital in Belgium

In Brussels, pre-hospital use of LUCAS was implemented at the Brugmann University Hospital (Paul Brien Site) at the end of 2004. It was immediately found that LUCAS improved the management when treating cardiac arrest patients. LUCAS compressions were also found to improve the patients’ blood pressure with some patients showing signs of life despite being in cardiac arrest.

Analysis of the results showed that LUCAS doubled the number of patients who achieved ROSC compared to historical data with manual CPR. Comparison with a contemporary patient group where LUCAS had not been available and manual CPR was administered likewise showed that LUCAS doubled the number of patients with ROSC.

ROSC = Return of spontaneous circulation

To read the complete article please download the document below. The original French publication has been translated into English. By courtesy of Y. Maule, Brussels, Belgium.

Maule L assistance cardiaque 2007 En Fr.pdf

Maule Y. “L’assistance cardiaque externe: nouvelle approche dans la RCP.” (“Mechanical external chest compression: a new adjuvant technology in cardiopulmonary resuscitation”.) Urgences & Accueil. 2007 (7); 29: 4-7

In Lübeck, Germany, cardiac arrest patients are resuscitated with
prolonged and effective LUCAS CPR

The hospital in Lübeck has good experience of using LUCAS in cases of cardiac arrest where defibrillation is not possible, for example pulseless electrical activity or asystole. With LUCAS maintaining effective and continuous CPR, sometimes for over an hour, the personnel has been able to find and treat the cause of cardiac arrest and save the patient, achieving a good neurological outcome. Several of the cardiac arrrests were caused by large fulminant pulmonary embolisms which dissolved after a prolonged period of LUCAS CPR, or by myocardial infarctions which were treated with PCI during ongoing LUCAS CPR.

The two articles below by Dr Bonnemeier, Lübeck and co-authors provide an overview of in-hospital cardiac arrest treatment and describe the clinical and practical advantages of the LUCAS Chest Compression System. By courtesy of Dr Bonnemeier, Lübeck, Germany.

Bonnemeier H; Cardiovasc 2008;8 (2): 20-25: Kardiopulmonale Reanimation: Bessere Überlebenswahrscheinlichkeit durch mechanische Herzdruckmassage (article in German)

Bonnemeier Improved survival 2008, ENG & DE.pdf

Bonnemeier H, Olivecrona G K. “The decisive role of effective continuous chest compression for in-hospital resuscitation of pulseless electrical activity” Resuscitation. 2008; 77S: S7, AS-019

More references on in- and pre-hospital use of LUCAS

Verstraete S, De Knock J, Müller N, Martens P, Van den Brande F, Vandevelde K. “Does the use of LUCAS influence survival for in-hospital cardiac arrest patients?”. ERC congress 2008; Poster 240 (on file at Jolife).

Verstraete Does the use of LUCAS 2008 p-ERC.pdf

Axelsson C, Nestin J, Svensson L, Axelsson Å, Herlitz J. “Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of out-of-hospital cardiac arrest - a pilot study.” Resuscitation. 2006; 71: 47-55

Axelsson et al. Resuscitation. 2006; 71:47-55

Gillis M, Keirens A, Steinkamm C, Verbelen J, Muysoms W, Reynders N. “The use of LUCAS and the Boussignac tube in the pre-hospital setting”. ERC congress 2008, Poster 219 (on file at Jolife)

Gillis The use of LUCAS 2008 p-ERC.pdf

Durnez P, Stockman W, Wynendaele R, Germonpre P, Dobbels P. “ROSC and neurologic outcome after in-hospital cardiac arrest and LUCAS-CPR”. Resuscitation. 2008; 77S: S49, AP-033, and ERC congress 2008; Poster 033 (on file at Jolife)

Durnez ROSC and neurological 2008 p-ERC .pdf

de Knock J, Martens P, Müller N, Van den Brande F. “The use of LUCAS for in- and out-of-hospital cardiac arrests.” Resuscitation. 2006; 70 (2): 305

Halliwell D, Box M. “Evaluation of LUCAS by Dorset Ambulance Service.” British journal of resuscitation. 2004; 3 (2): 10-11

Bonnemeier H, Olivecrona G, Simonis G, Götberg M, Weitz G, Iblher P, Gerling I, Schunkert I. “Automated continuous chest compression for in-hospital cardiopulmonary resuscitation of patients with pulseless electrical activity: A report of five cases”. International Journal of Cardiology. 2008; Aug (e-pub ahead of print)

Bonnemeier et al; Int J Cardiol. 2008 Aug 6

Vatsgar TT, Ingebrigtsen O, Fjosea LO, Wikstrøm B, Nilsen JE, Wik L. “Cardiac arrest and resuscitation with an automatic mechanical chest compression device (LUCAS) due to anaphylaxis of a woman receiving caesarean section because of pre-eclampsia.” Resuscitation. 2006; 68: 155-159

Vatsgar et al; Resuscitation. 2006 Jan;68(1):155-9

Holmström P, Boyd J, Sorsa M, Kuisma M. “A case of hypothermic cardiac arrest treated with an external chest compression device (LUCAS) during transport to re-warming.” Resuscitation. 2005; 67: 139-141

Holmström et al; Resuscitation. 2005 Oct;67(1):139-41

Wik L, Kiil S. “Use of an automatic chest compression device (LUCAS) as a bridge to establishing cardiopulmonary bypass for a patient with hypothermic cardiac arrest.” Resuscitation. 2005; 66: 391-394

Wik et al; Resuscitation. 2005; 66: 391-394

Nielsen N, Sandhall L, Scherstén F, Friberg H, Olsson SE. ”Successful resuscitation with mechanical CPR, therapeutic hypothermia and coronary intervention during manual CPR after out-of-hospital cardiac arrest.” Resuscitation. 2005; 65: 111-113

Nielsen et al; Resuscitation. 2005 Apr;65(1):111-3

Please note: LUCAS™ Chest Compression System is available in different versions, with different power solutions. All versions provide chest compressions according to AHA and ERC guidelines. Most publications and studies are done on LUCAS™1.

The pneumatic LUCAS™1 (V1 and V2) are CE marked, and LUCAS™1 (V2) has a 510k clearance for marketing in the US, is approved in Japan and has several international registrations.

The electric LUCAS™2 is CE-marked for sales in Europe, approved in Canada and has a 510k clearance for marketing in the US.

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