Manual Chest Compression vs Use of an Automated Chest Compression Device During Resuscitation Following Out-of-Hospital Cardiac Arrest

Hallstrom, Al; Rea, Thomas D.; Sayre, Michael R.; Christenson, James M.; Anton, Andy R.; Mosesso, Vince N.; Ottingham, Lois Van; Olsufka, Michele; Pennington, Sarah; White, Lynn J.; Yahn, Stephen; Husar, James; Morris, Mary; Cobb, Leonard A.

doi:10.1001/jama.295.22.2620

Cited by 336 publications

(165 citation statements)

References 38 publications

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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%

See 1 more Smart Citation

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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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%

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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“…5 It is intuitive that mechanical devices should provide superior CPR quality compared to human rescuers as length of resuscitation increases, particularly when the number of available rescuers is limited. Recent randomized controlled trials regarding the effectiveness of different mechanical CPR devices on neurologically intact survival after cardiac arrest have shown similar CPR quality metrics when compared to manual CPR [21][22][23] but no improvements in clinical outcomes. Some EMS systems have adopted the view that mechanical CPR devices improve paramedic safety while transporting victims of cardiac arrest to the hospital.…”

Section: Mechanical Cprmentioning

confidence: 99%

The impact of prehospital resuscitation research on in-hospital care

Mausz

Cheskes

2015

CJEM

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Since their introduction over 40 years ago, paramedics have been trained to deliver select advanced life support interventions in the community with the goal of reducing morbidity and mortality from cardiovascular disease and trauma. The ensuing decades witnessed a great deal of interest in paramedic care, with an exponential growth in prehospital resuscitation research. As part of the CJEM series on emergency medical services (EMS), we review recent prehospital research in out-of-hospital cardiac arrest and discuss how, in a novel departure from the origins of EMS, prehospital research is beginning to influence in-hospital care. We discuss emerging areas of study related to cardiopulmonary resuscitation (CPR) quality, therapeutic hypothermia, termination of resuscitation, and the use of end-tidal carbon dioxide measurement, as well as the subtle ripple effects that prehospital research is having on the broader understanding of the management of these critically ill patients. RÉSUMÉDepuis leur arrivée il y a plus d'une quarantaine d'années, les ambulanciers paramédicaux sont formés pour pratiquer certaines interventions de réanimation cardiorespiratoire (RCR) médicalisée dans la collectivité dans le but de réduire la morbidité et la mortalité liées aux maladies cardiovasculaires et aux traumas. Au cours des décennies suivantes, les soins paramédicaux ont suscité un vif intérêt, qui s'est accompagné d'une forte croissance de la recherche en réanimation préhospitalière. Dans le cadre de la série d'articles portant sur les services médi-caux d'urgence (SMU) dans le JCMU, il sera question de la recherche récente sur la prise en charge préhospitalière des arrêts cardiaques qui surviennent dans la collectivité ainsi que de l'influence que commence à avoir la recherche dans le domaine préhospitalier sur les soins hospitaliers, influence qui signe une nouvelle orientation par rapport au point de départ des SMU. L'article portera sur de nouveaux champs d'étude liés à la qualité de la RCR, à l'hypothermie thérapeutique, à l'arrêt des manoeuvres de réanimation et à l'utilisation de la mesure du gaz carbonique en fin d'expiration ainsi que sur les effets d'entraînement discrets que la recherche dans le domaine préhospitalier a sur la compréhension élargie du traitement des personnes gravement malades ou blessées.

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“…Obwohl der Einsatz der LDB-CPR die Hämodynamik des Patienten verbessert [592,593,594], ergaben klinische Studien widersprüchliche Ergebnisse. In einer multizentrischen ran-domisierten klinischen Studie mit über 1000 dokumentierten Anwendungen an erwachsenen Patienten konnte keine Verbesserung des 4-h-Überlebens erzielt werden, und die Anwendung der LDB-CPR durch den Rettungsdienst bei prähospi-talem Kreislaufstillstand ging mit einem verschlechterten neurologischen Outcome einher [595]. Eine Post-hoc-Analyse dieser Studie beschrieb jedoch eine relevante und signifikante Heterogenität zwischen den Studiengruppen [599].…”

Section: Kardiopulmonale Reanimation Mithilfe Des "Load-distributing unclassified

“…Andere nichtrandomisierte klinische Studien berichteten von erhöhten Raten an stabilem ROSC [597,598], einer erhöhten Entlassungsrate nach präklinischem Kreislaufstillstand [598] und einer verbesserten Hämodyna-mik bei primär nichterfolgreicher Reanimation innerklinischer Kreislaufstillstän-de [592]. Ergebnisse von klinischen [595,599] und Simulationsstudien [600] lassen vermuten, das lokale Rahmenbedingungen die Qualität der Reanimation und den Erfolg der Anwendung der LDB-CPR mitbeeinflussen. …”

Section: Kardiopulmonale Reanimation Mithilfe Des "Load-distributing unclassified

Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)

Deakin

Nolan

Soar

et al. 2010

Notfall Rettungsmed

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Manual Chest Compression vs Use of an Automated Chest Compression Device During Resuscitation Following Out-of-Hospital Cardiac Arrest

Abstract: clinicaltrials.gov Identifier: NCT00120965.

Cited by 336 publications

References 38 publications

The impact of prehospital resuscitation research on in-hospital care

Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)

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