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The Study Protocol for the LINC (LUCAS in Cardiac Arrest) Study: a study comparing conventional adult out-of-hospital cardiopulmonary resuscitation with a concept with mechanical chest compressions and simultaneous defibrillation

Sten Rubertsson1*, Johan Silfverstolpe2, Liselott Rehn2, Thomas Nyman2, Rob Lichtveld3, Rene Boomars3, Wendy Bruins3, Björn Ahlstedt4, Helena Puggioli4, Erik Lindgren1, David Smekal1, Gunnar Skoog5, Robert Kastberg5, Anna Lindblad5, David Halliwell6, Martyn Box6, Fredrik Arnwald7, Bjarne Madsen Hardig7, Douglas Chamberlain8, Johan Herlitz109 and Rolf Karlsten1

Author Affiliations

1 Department of Surgical Sciences/Anaesthesiology & Intensive Care, Uppsala University, Uppsala, Sweden

2 Region Skånes Prehospitala Centrum, Skånes University Hospital, Lund, Sweden

3 Regional Ambulance Service Utrecht, Utrecht, Netherlands

4 Västerås central hospital, Västerås, Sweden

5 Gävle center hospital, Gävle, Sweden

6 South Western Ambulance Service NHS Foundation Trust, Abbey Court, Eagle way, Exeter, United Kingdom

7 Physio-Control/Jolife AB, Ideon Science Park, 223 70, Lund, Sweden

8 Institute of Primary Care and Public Health, Cardiff University School of Medicine, Cardiff, United Kingdom

9 The Center of Prehospital Research in Western Sweden, University College of Borås, Borås, Sweden

10 The Center of Prehospital Research in Western Sweden, Sahlgrenska University Hospital, Göteborg, Sweden

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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2013, 21:5  doi:10.1186/1757-7241-21-5

Published: 25 January 2013



The LUCAS™ device delivers mechanical chest compressions that have been shown in experimental studies to improve perfusion pressures to the brain and heart as well as augmenting cerebral blood flow and end tidal CO2, compared with results from standard manual cardiopulmonary resuscitation (CPR). Two randomised pilot studies in out-of-hospital cardiac arrest patients have not shown improved outcome when compared with manual CPR. There remains evidence from small case series that the device can be potentially beneficial compared with manual chest compressions in specific situations. This multicentre study is designed to evaluate the efficacy and safety of mechanical chest compressions with the LUCAS™ device whilst allowing defibrillation during on-going CPR, and comparing the results with those of conventional resuscitation.


This article describes the design and protocol of the LINC-study which is a randomised controlled multicentre study of 2500 out-of-hospital cardiac arrest patients. The study has been registered at ( webcite).


Primary endpoint is four-hour survival after successful restoration of spontaneous circulation. The safety aspect is being evaluated by post mortem examinations in 300 patients that may reflect injuries from CPR.


This large multicentre study will contribute to the evaluation of mechanical chest compression in CPR and specifically to the efficacy and safety of the LUCAS™ device when used in association with defibrillation during on-going CPR.

Cardiac arrest; Mechanical chest compression; Defibrillation; External chest compressions; Ventricular fibrillation; Asystole; Pulseless electrical activity