Abstract
BackgroundThe aim of this paper was to conduct a systematic review of the published literatures comparing the use of mechanical chest compression device and manual chest compression during cardiac arrest (CA) with respect to short-term survival outcomes and neurological function.MethodsDatabases including MEDLINE, EMBASE, Web of Science and the ClinicalTrials.gov registry were systematically searched. Further references were gathered from cross-references from articles by handsearch. The inclusion criteria for this review must be human prospective controlled studies of adult CA. Random effects models were used to assess the risk ratios and 95 % confidence intervals for return of spontaneous circulation (ROSC), survival to admission and discharge, and neurological function.ResultsTwelve trials (9 out-of-hospital and 3 in-hospital studies), involving 11,162 participants, were included in the review. The results of this meta-analysis indicated no differences were found in Cerebral Performance Category (CPC) scores, survival to hospital admission and survival to discharge between manual cardiopulmonary resuscitation (CPR) and mechanical CPR for out-of-hospital CA (OHCA) patients. The data on achieving ROSC in both of in-hospital and out-of-hospital setting suggested poor application of the mechanical device (RR 0.71, [95 % CI, 0.53, 0.97] and 0.87 [95 % CI, 0.81, 0.94], respectively). OHCA patients receiving manual resuscitation were more likely to attain ROSC compared with load-distributing bands chest compression device (RR 0.88, [95 % CI, 0.80, 0.96]). The in-hospital studies suggested increased relative harm with mechanical compressions for ratio of survival to hospital discharge (RR 0.54, [95 % CI 0.29, 0.98]). However, the results were not statistically significant between different kinds of mechanical chest compression devices and manual resuscitation in survival to admission, discharge and CPC scores for OHCA patients and survival to discharge for in-hospital CA patients.ConclusionsThe ability to achieve ROSC with mechanical devise was inferior to manual chest compression during resuscitation. The use of mechanical chest compression cannot be recommended as a replacement for manual CPR, but rather a supplemental treatment in an overall strategy for treating CA patients.
Highlights
The aim of this paper was to conduct a systematic review of the published literatures comparing the use of mechanical chest compression device and manual chest compression during cardiac arrest (CA) with respect to short-term survival outcomes and neurological function
Types of studies A meta-analysis was performed to compare any type of mechanical chest compression device with manual chest compression in the management of patients suffered from CA in out-of-hospital and in-hospital settings
Three different mechanisms of mechanical chest compression devices including load-distributing bands (LDBs) (AutoPulse), Survival to hospital admission 8 studies comprising a total of 9975 of-hospital CA (OHCA) patients met the selection criteria
Summary
The aim of this paper was to conduct a systematic review of the published literatures comparing the use of mechanical chest compression device and manual chest compression during cardiac arrest (CA) with respect to short-term survival outcomes and neurological function. Machines have been developed to take over this chest pumping action using pneumatically driven or load-distributing bands (LDBs) mechanisms, because the machines do not pause or get tired, and deliver uninterrupted chestcompressions with a predefined depth and rate [13]. Some studies using those machines for chest compressions have shown that they could achieve intrathoracic pressures higher, improve coronary and systemic perfusion pressures and flows compared with manual CPR in animal models and in a small number of terminally ill patients [14,15,16]. We aimed to investigate which method of chest compression (applying the traditional manual compression vs. using a machine) would result in more lives saved
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