Abstract
ObjectivesTo evaluate the resuscitative effects of mechanical and manual chest compression in patients with out-of-hospital cardiac arrest (OHCA).MethodsAll randomized controlled and cohort studies comparing the effects of mechanical compression and manual compression on cardiopulmonary resuscitation in OHCA patients were retrieved from the Cochrane Library, PubMed, EMBASE, and Ovid databases from the date of their establishment to January 14, 2019. The included outcomes were as follows: the return of spontaneous circulation (ROSC) rate, the rate of survival to hospital admission, the rate of survival to hospital discharge, and neurological function. After evaluating the quality of the studies and summarizing the results, RevMan5.3 software was used for the meta-analysis.ResultsIn total, 15 studies (9 randomized controlled trials and 6 cohort studies) were included. The results of the meta-analysis showed that there were no significant differences in the resuscitative effects of mechanical and manual chest compression in terms of the ROSC rate, the rate of survival to hospital admission and survival to hospital discharge, and neurological function in OHCA patients (ROSC: RCT: OR = 1.12, 95% CI (0.90, 1.39), P = 0.31; cohort study: OR = 1.08, 95% CI (0.85, 1.36), P = 0.54; survival to hospital admission: RCT: OR = 0.95, 95% CI (0.75, 1.20), P = 0.64; cohort study: OR = 0.98 95% CI (0.79, 1.20), P = 0.82; survival to hospital discharge: RCT: OR = 0.87, 95% CI (0.68, 1.10), P = 0.24; cohort study: OR = 0.78, 95% CI (0.53, 1.16), P = 0.22; Cerebral Performance Category (CPC) score: RCT: OR = 0.88, 95% CI (0.64, 1.20), P = 0.41; cohort study: OR = 0.68, 95% CI (0.34, 1.37), P = 0.28). When the mechanical compression group was divided into Lucas and Autopulse subgroups, the Lucas subgroup showed no difference from the manual compression group in ROSC, survival to admission, survival to discharge, and CPC scores; the Autopulse subgroup showed no difference from the manual compression subgroup in ROSC, survival to discharge, and CPC scores.ConclusionThere were no significant differences in resuscitative effects between mechanical and manual chest compression in OHCA patients. To ensure the quality of CPR, we suggest that manual chest compression be applied in the early stage of CPR for OHCA patients, while mechanical compression can be used as part of advanced life support in the late stage.
Highlights
Out-of-hospital cardiac arrest (OHCA) is a sudden cardiac arrest and loss of consciousness that occurs outside of a hospital
Li et al [12] performed a meta-analysis of in-hospital and out-of-hospital CA patients in 2016 and showed that for out-of-hospital CA, there was no significant difference in Cerebral Performance Category (CPC) score, admission survival rate, and discharge survival rate between manual compression and mechanical compression, and that manual compression was superior to mechanical compression in the rate of spontaneous circulation recovery, especially superior to mechanical compression provided by Autopulse
There were no significant differences in the rate of return of spontaneous circulation (ROSC), rate of survival to admission, rate of survival to discharge, and neurological function scores between the manual compression and mechanical compression groups
Summary
Out-of-hospital cardiac arrest (OHCA) is a sudden cardiac arrest and loss of consciousness that occurs outside of a hospital. For CPR in patients with OHCA, both manual and mechanical compression have advantages and disadvantages, and there is no consensus regarding their effects and outcomes. That meta-analysis included 7 randomized controlled trials (RCTs), it used network meta-analysis and showed that the 30-day survival rate, the discharge survival rate, and the nervous system function of those treated with manual compression were significantly better than those treated with the load distribution provided by Autopulse and were not significantly different from those treated with mechanical compression provided by Lucas. The conclusions drawn by these studies are not reliable We conducted this meta-analysis, which includes the latest RCTs with OHCA patients and cohort studies, to investigate and compare the effects of mechanical and manual compression on the survival and prognosis of OHCA patients. We retrieved 4 new RCTs and divided the studies into Lucas and Autopulse subgroups to further determine the advantages and disadvantages of mechanical compression and manual compression
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
