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Byline: Gilles A Orliaguet, Pierre A Carli, Alain Rozenberg, Daniel Janniere, Patrick Sauval, Philippe Delpech Abstract: Study objectives: To compare the maximal end-tidal carbon dioxide pressure (ETCO.sub.2 peak) values obtained during standard (S-CPR) and active compression-decompression CPR (ACD-CPR) during prolonged resuscitation in out-of-hospital cardiac arrest. Design: Prospective, randomized crossover study. Setting: City with a population of 3.5 million, served by an emergency medical service system providing advanced cardiac life support. Participants: Patients with nontraumatic out-of-hospital cardiac arrest. Interventions: Patients were randomly assigned to receive first, for a period of 3 minutes, either ACD-CPR or S-CPR; then the two methods were alternated. ETCO.sub.2 was continuously monitored and computed. Measurements and Results: Sixteen patients (48[+ or -]20 years old) were included; in 12, return of spontaneous circulation was achieved, and 5 were admitted alive to the hospital. A statistically significant increase in ETCO.sub.2 peak was obtained with ACD-CPR (27.6[+ or -]3 mm Hg) compared with S-CPR (15.6[+ or -]2.2 mm Hg). No major adverse effect possibly related to ACD-CPR was observed. Conclusion: This prospective study suggests that ACD-CPR may improve cardiac output compared with S-CPR. [Orliaguet GA, Carli PA, Rozenberg A, Janniere D, Sauval P, Delpech P: End-tidal carbon dioxide during out-of-hospital cardiac arrest resuscitation: Comparison of active compression-decompression and standard CPR. Ann Emerg Med January 1995;25:48-51.] Article History: Received 6 April 1994; Revised 8 July 1994; Accepted 13 July 1994 Article Note: (footnote) [star] From the Service d'Aide Medicale Urgente 9SAMU) de Paris, Department of Anesthesiology, HA[acute accent]spital Necker., [star][star] No financial support for this study was provided by Ambu International, nor are any of the authors affiliated with this company., a Address for reprints: Professor Pierre A Carli, SAMU de Paris, Department of Anesthesiology, HA[acute accent]pital Necker, 149 rue de Sevres, 75015 Paris, France, 33-1-44-49-23-23, Fax 33-1-44-49-24-24, aa Reprint no. 47/1/60938