Manual Cardiopulmonary Resuscitation Versus CPR Including a Mechanical Chest Compression Device in Out-of-Hospital Cardiac Arrest: A Comprehensive Meta-analysis From Randomized and Observational Studies

Bonnes, Judith L.; Brouwer, Marc A.; Navarese, Eliano Pio; Verhaert, Dominique V M; Verheugt, Freek W.A.; Smeets, Joep L.R.M.; Boer, Menko‐Jan de

doi:10.1016/j.annemergmed.2015.09.023

Cited by 92 publications

(90 citation statements)

References 36 publications

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“…19 Although MCCDs may contribute to improve the patient outcome when the cardiac arrest occurs in hospital, 20 some meta-analysis have reported that automated CPR versus manual CPR does not improve survival or neurologic outcome in out-of-hospital cardiac arrest. 21,22 It can be argued that the specific characteristics of environment, resuscitation, and transport reproduced in our study could be ideal to test the performance of MCCDs in this setting and to compare them with manual CPR. Potential advantages of MCCDs could be the continuity of CCs; avoiding hands-off time; and the maintenance of CC depth, rate, and decompression values along the time.…”

Section: Discussionmentioning

confidence: 97%

Cardiopulmonary Resuscitation Quality by Helicopter Rescue Swimmers While Flying

Abelairas‐Gómez

Vázquez-González

García

et al. 2016

Air Medical Journal

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Section: Discussionmentioning

confidence: 97%

Cardiopulmonary Resuscitation Quality by Helicopter Rescue Swimmers While Flying

Abelairas‐Gómez

Vázquez-González

García

et al. 2016

Air Medical Journal

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“…Observational studies provide useful insights in to the effectiveness of interventions, but are prone to biases, such as selection bias and the recently described resuscitation time bias [24, 25]. In the out-of-hospital setting, observational studies of mech-CPR have produced inconsistent findings [26–28]. In contrast, findings of high-quality large randomised controlled trials have produced consistent results, showing no benefit in the routine use of mech-CPR compared with man-CPR [10].…”

Section: Discussionmentioning

confidence: 99%

Mechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm: a randomised controlled feasibility trial (COMPRESS-RCT)

Couper

Quinn

Lall

et al. 2018

Scand J Trauma Resusc Emerg Med

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BackgroundMechanical chest compression devices consistently deliver high-quality chest compressions. Small very low-quality studies suggest mechanical devices may be effective as an alternative to manual chest compressions in the treatment of adult in-hospital cardiac arrest patients. The aim of this feasibility trial is to assess the feasibility of conducting an effectiveness trial in this patient population.MethodsCOMPRESS-RCT is a multi-centre parallel group feasibility randomised controlled trial, designed to assess the feasibility of undertaking an effectiveness to compare the effect of mechanical chest compressions with manual chest compressions on 30-day survival following in-hospital cardiac arrest.Over approximately two years, 330 adult patients who sustain an in-hospital cardiac arrest and are in a non-shockable rhythm will be randomised in a 3:1 ratio to receive ongoing treatment with a mechanical chest compression device (LUCAS 2/3, Jolife AB/Stryker, Lund, Sweden) or continued manual chest compressions. It is intended that recruitment will occur on a 24/7 basis by the clinical cardiac arrest team. The primary study outcome is the proportion of eligible participants randomised in the study during site operational recruitment hours. Participants will be enrolled using a model of deferred consent, with consent for follow-up sought from patients or their consultee in those that survive the cardiac arrest event.The trial will have an embedded qualitative study, in which we will conduct semi-structured interviews with hospital staff to explore facilitators and barriers to study recruitment.DiscussionThe findings of COMPRESS-RCT will provide important information about the deliverability of an effectiveness trial to evaluate the effect on 30-day mortality of routine use of mechanical chest compression devices in adult in-hospital cardiac arrest patients.Trial registrationISRCTN38139840, date of registration 9th January 2017.Electronic supplementary materialThe online version of this article (10.1186/s13049-018-0538-6) contains supplementary material, which is available to authorized users.

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“…On the basis of the previous studies,10, 17, 18, 19, 20, 21, 22, 23, 24 we selected adult patients with nontraumatic OHCA who had sustained circulatory arrest on hospital arrival (thus, all eligible patients who attended the ED received ongoing CPR by EMS). The inclusion criteria were as follows: (1) age ≥18 years, (2) patients with undetectable blood pressure on hospital arrival, (3) patients who received advanced cardiovascular life support after hospital arrival, and (4) patients who were transferred to hospitals that had an mCPR device.…”

Section: Methodsmentioning

confidence: 99%

“…The primary outcome was survival to hospital discharge 10, 19, 20, 21, 23, 24. The secondary outcomes included ROSC10, 17, 18, 19, 20, 21 and successful hospital admission 10, 18, 19, 20, 21, 22…”

Section: Methodsmentioning

confidence: 99%

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Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out‐of‐Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS‐KANTO [Survey of Survivors after Out‐of‐Hospital Cardiac Arrest in Kanto Area] 2012 Study)

Hayashida

Tagami

Fukuda

et al. 2017

JAHA

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BackgroundMechanical cardiopulmonary resuscitation (mCPR) for patients with out‐of‐hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes.Methods and ResultsIn a prospective, multicenter, observational study, adult patients with out‐of‐hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and within‐institution clustering effects using a generalized estimation equation were used to analyze the association of the mCPR with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with out‐of‐hospital cardiac arrest were eligible; this included 5619 patients (86.0%) in the manual CPR group and 918 patients (14.0%) in the mCPR group. Of those patients, 28.1% (1801/6419) showed return of spontaneous circulation in the emergency department, 20.4% (1175/5754) had hospital admission, 2.6% (168/6504) survived to hospital discharge, and 1.2% (75/6419) showed a favorable neurological outcome at 1 month after admission. Multivariate analyses revealed that mCPR was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95% confidence interval, 0.20–0.78; P=0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95% confidence interval, 0.53–0.94; P=0.018), and hospital admission (adjusted odds ratio, 0.57; 95% confidence interval, 0.40–0.80; P=0.001).ConclusionsAfter accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out‐of‐hospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients.

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Manual Cardiopulmonary Resuscitation Versus CPR Including a Mechanical Chest Compression Device in Out-of-Hospital Cardiac Arrest: A Comprehensive Meta-analysis From Randomized and Observational Studies

Cited by 92 publications

References 36 publications

Cardiopulmonary Resuscitation Quality by Helicopter Rescue Swimmers While Flying

Cardiopulmonary Resuscitation Quality by Helicopter Rescue Swimmers While Flying

Mechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm: a randomised controlled feasibility trial (COMPRESS-RCT)

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