A Review of CPR Augmentation Devices

The study aims to assess cardiopulmonary resuscitation (CPR) outcomes in cardiac arrest patients when using CPR augmentation devices, such as the ZOLL ResQCPR system (Chelmsford, MA) or its components ResQPUMP and ResQPOD, which are manual active compression-decompression (ACD) device and impedance threshold device (ITD), respectively. The analysis included a Google Scholar-based literature review that took place between January 2015 and March 2023 and included recent publications with PubMed IDs or widely cited articles to assess the effectiveness of the ResQPUMP and ResQPOD or similar devices. This review also includes studies quoted by ZOLL, but those were not considered in our conclusion since the authors were employed by ZOLL. We found that in a study on human cadavers, the force of decompression increased the chest compliance of the chest wall by 30%-50% (p<0.05). Essentially, active compression-decompression improved the return of spontaneous circulation (ROSC) with meaningful neurologic outcomes by 50% in a blinded, randomized, and controlled human trial (n=1,653; p<0.02). The main study on the ResQPOD had a controversial human data pool with one randomized and controlled study arguing for no significant difference with or without the device (n=8,718; p=0.71). However, a post hoc analysis and the reorganization of the data by CPR quality demonstrated significance (n decreased to 2,799, reported in odds ratio without specific p-values). In conclusion to the limited number of studies presented, any manual ACD device is a great alternative to standard cardiopulmonary resuscitation regarding survivability with good neurologic function and should be utilized in prehospital emergency medical services and hospital emergency departments. ITDs are still controversial but promising with more future data.