Evaluation of the LUCAS™ Chest Compression System for Automatic Mechanical Compression and Decompression Resuscitation in the Catheterization Laboratory – Report of a Ten Years’ Experience

Ischemia due to reduced coronary artery flow is the most frequent cause of cardiac arrest (CA(. Quality of cardiopulmonary resuscitation (CPR) is a key determinant of outcome, but manual chest compressions in the catheterization laboratory does not allow to perform PCI. Mechanical chest compression systems have been developed as adjuncts for CPR and allow in parallel to perform PCI. We report our experience with the use of the chest compression system in the catheterization laboratory.

Methods: We included in a prospective single tertiary care center registry all patients in whom the system was used.

Results: In a 10 year period, mechanical chest compression with the LUCAS device was performed in 41 patients, out of 19,600 procedures. The patients were admitted with ST-elevation myocardial infarction (STEMI) in 78% of cases, Non STEMI (10%), Ventricular fibrillation (5%), Aortic valve stenosis (5%) and Asystole (2%). A total of 39 PCIs were attempted in the 41 patients. 25 patients (61%) were alive at the end of the procedure and were transferred from the catheterization laboratory to the intensive care unit with return of spontaneous circulation (ROSC). Of the 25 patients who survived in the catheterization laboratory, 20 died within the first 30 days, most of them in the few hours after the end of the CPR effort. Five patients survived more than 1 year after the procedure.

Conclusions: Effective manual CPR and effective PCI are almost impossible to perform simultaneously. Coronary angiography and PCI is feasible during continuous mechanical chest compressions. This is a vital alternative approach in cardiac arrest patients.