Purpose. In a randomized clinical outcome study of out of hospital cardiac arrest (OHCA), the load distributing band device (LDB, AutoPulse®, Zoll Medical Corporation, Chelmsford, MA, USA) did not improve survival to hospital discharge compared to high quality manual CPR. Few studies have explored the effect of the LDB device in standard clinical use with conflicting results. We sought to assess whether the use of the LBD device could affect survival to hospital discharge in the different Utstein categories.
Materials and Methods. All consecutive patients enrolled in our provincial cardiac arrest registry (Pavia CARe) from January 2015 to December 2017 were included and pre-hospital data were computed as well as survival to hospital discharge.
Results. Among 1403 resuscitation attempts the LDB device was used in 235 (18%) patients. Survival to hospital admission and discharge in the LDB group compared to the manual group was 30% vs 14% (p<0.001) and 10% vs 7% (p=0.2), respectively. The LDB device was significantly more used for shockable cardiac arrest (38% vs 12%, p<0.001).  LBD use was a strong independent predictor of survival to hospital discharge for witnessed non-shockable OHCA [n=624/1403, OR 10.5 (95%CI 1.3-82.2) p=0.028]. For witnessed shockable cardiac arrest and for non-witnessed and non-shockable cardiac arrest the use of a LDBD was not associated with an increased survival neither to hospital admission nor to hospital discharge.
Conclusion. Utstein categories-based analysis showed that the LDB device positively affect survival to hospital discharge for witnessed non-shockable cardiac arrests but not for shockable arrest and non-witnessed non-shockable arrests.

1 - Mechanical CPR with a load distributing band device in out-of-hospital cardiac arrest. An Utstein categories based analysis