Abstract
Recent evidence regarding mechanical chest compressions in out-of-hospital cardiac arrest (OHCA) is conflicting. The objective of this study was to perform a meta-analysis of randomized controlled trials (RCTs) to compare the effect of mechanical versus manual chest compressions on resuscitation outcomes in OHCA. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the ClinicalTrials.gov registry were searched. In total, five RCTs with 12,510 participants were included. Compared with manual chest compressions, mechanical chest compressions did not significantly improve survival with good neurological outcome to hospital discharge (relative risks (RR) 0.80, 95% CI 0.61–1.04, P = 0.10; I2 = 65%), return of spontaneous circulation (RR 1.02, 95% CI 0.95–1.09, P = 0.59; I2 = 0%), or long-term (≥6 months) survival (RR 0.96, 95% CI 0.79–1.16, P = 0.65; I2 = 16%). In addition, mechanical chest compressions were associated with worse survival to hospital admission (RR 0.94, 95% CI 0.89–1.00, P = 0.04; I2 = 0%) and to hospital discharge (RR 0.88, 95% CI 0.78–0.99, P = 0.03; I2 = 0%). Based on the current evidence, widespread use of mechanical devices for chest compressions in OHCA cannot be recommended.
Highlights
Observational studies with respect to managing risk of bias, in order to provide the latest and solid evidence, we conducted a meta-analysis of RCTs comparing the effect of mechanical versus manual chest compressions on survival and neurological outcomes in participants with of-hospital cardiac arrest (OHCA)
Mechanical chest compressions did not significantly improve survival with good neurological outcome to hospital discharge (RR 0.80, 95% confidence intervals (CIs) 0.61–1.04, P = 0.10; I2 = 6 5%; Fig. 3) compared with manual chest compressions
Compared with manual chest compressions, mechanical chest compressions were associated with worse survival to hospital admission (RR 0.94, 95% CI 0.89–1.00, P = 0.04, I2 = 0%; Fig. 4), and to hospital discharge (RR 0.88, 95% CI 0.78–0.99, P = 0.03; I2 = 0 %; Fig. 5)
Summary
Ethical approval and patient consent were not required since this was a meta-analysis of previously published studies. Two authors (Tang L and Gu WJ) independently assessed the eligibility of all studies identified in initial research. Studies meeting the following criteria were included: (1) population: adult participants with non-traumatic OHCA; (2) intervention: mechanical chest compressions; (3) comparison: manual chest compressions and (4) design: RCTs. Agreement regarding trial inclusion was assessed using the Cohen К statistic[13]. Two authors (Tang L and Gu WJ) independently extracted the following data: first author, year of publication, study location, participant characteristics, mechanical compression device, resuscitation strategy, adverse events, and main outcomes using a standard form. Secondary outcomes included survival to hospital admission, survival to hospital discharge, ROSC and long-term (≥ 6 months) survival. Two authors (Tang L and Gu WJ) independently assessed risk of bias in included RCTs with the method recommended by the Cochrane Collaboration[16]. All statistical analyses were conducted using Review Manager software (version 5.3; Nordic Cochrane Centre, Cochrane Collaboration)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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.
