Cardiovascular risk factors differently affect the survival of patients undergoing manual or mechanical resuscitation

Abstract

BackgroundChest compression is a decisive element of cardio-pulmonary resuscitation (CPR). By applying a mechanical CPR device, compression interruptions can be minimised. We examined the efficiency of manual and device-assisted resuscitation as well as the effects of cardiovascular risk factors on the outcome of resuscitation.MethodsIn our retrospective, randomised 3-year study the data of adult patients suffering non-traumatic, out-of-hospital, sudden cardiac death (SCD) were analysed (n = 287). The data were retrieved by processing case reports, Utstein sheets and acute coronary syndrome sheets. We compared the data of patients undergoing manual (n = 232) and device-assisted resuscitation (LUCAS-2, n = 55). The primary endpoint was the on-site restoration of spontaneous circulation (ROSC).Results and conclusionIn 37% of the cases ROSC happened. With respect to ROSC an insignificantly more favourable tendency was demonstrated in the case of device-assisted resuscitation (p = 0.072). In the Lucas group, a higher success rate occurred even in the case of prolonged resuscitation. We found a better outcome in the Lucas group in the case of CPR started a longer time after the SCD (p < 0.05). A positive correlation was established between age and unsuccessful resuscitation (p = < 0.017; r = 0.125). An unfavourable correlation was observed between hypertension and the outcome of resuscitation (p = 0.018; r = 0.143). According to our results the presence of left ventricular hypertrophy poses 5.1-fold risk of unsuccessful CPR (CI: 4.97–5.29).Advanced age and structural heart diseases can play a role in the genesis of SCD. Importantly, left ventricular hypertrophy and hypertension negatively affect survival.

High plasma levels of pro-inflammatory factors interleukin-17 and interleukin-23 are associated with poor outcome of cardiac-arrest patients: a single center experience

“…Due to the predicament that critical care interventions of PCAS patient is rather expensive and might be ethically problematic if the outcome is poor, predicting the shortand long-term outcomes in PCAS patients becomes a key challenge in the treatment of PCAS patients. To address this problem, discovering novel biomarkers in PACS patients' blood is valuable in the clinical therapy of PCAS patients [5]. Donnino et al reported that effective clearance of blood lactate during the early stage was associated with decreased overall mortality in patients with cardiac arrest [6].…”

Handling of Ventricular Fibrillation in the Emergency Setting

“…Herlitz et al examined the data of 33,453 patients and concluded that initial rhythm, lay resuscitation and the age of the patient very strongly influenced the outcome of CPR (Herlitz et al, 2005) Our own research findings have proven that the presence of left ventricular hypertrophy involved 5.1 times higher risk of the failure of resuscitation (p = 0.0009 r = 0.1995). We have also found that age and hypertension negatively influence success rate; in the case of hypertension there is a 1.82-time risk of a failed outcome (p = 0.018 r = 0.143) (Ujvárosy et al, 2018). Often the first and only 'symptom' of myocardial infarction is sudden cardiac death, and SCD was responsible for the death of almost half of the coronary patients and for nearly 325,000 deaths per year, in the USA (Myerburg et al, 1993;Singh and Noheria, 2018).…”

“…Also, in cases of prolonged resuscitation, success rate was higher in the mechanical group (p<0.05). The number of traumatic injuries was not higher in the LUCAS-2 compared to the manual group (Ujvárosy et al, 2018).…”

“…In view of the latter mechanical chest compression devices have become increasingly widespread and available as alternative solutions both in prehospital and in-hospital emergency care. With the help of these devices, high-quality compressions can be maintained even for a long time (Ujvárosy et al, 2018). Although the findings of the research performed have not yet confirmed significant differences in the outcome of resuscitations with the use of these devices, there are certain situations, e.g., continuous CPR during transport, when their application is clearly recommended by international guidelines (Soar et al, 2015).…”

Comparison between Prehospital Mechanical Cardiopulmonary Resuscitation (CPR) Devices and Manual CPR for Out-of-Hospital Cardiac Arrest: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis

“…It included studies published between 2006 and 2021, conducted in 16 countries across the continents of North America, Asia, Oceania, and Europe. In terms of automatic CPR devices, LUCAS was applied in 12 studies [ 18 , 19 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], AutoPulse was applied in seven studies [ 36 , 37 , 38 , 39 , 40 , 41 , 42 ], and three studies involved both devices [ 17 , 43 , 44 ].…”