Mechanical versus manual chest compressions for cardiac arrest: a systematic review and meta-analysis

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Xiaoli Jing²  Xiang Zhao²  Yi Yu²  Dongping Wang¹  Hui Li² 

[1] Department of Organ Transplantation, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China;Department of Emergency, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan 2nd Road, Guangzhou 510080, Guangdong, China

关键词: Meta-analysis;    Device;    Cardiopulmonary resuscitation;    Cardiac arrest;   

Others  :  1235803
DOI  :  10.1186/s13049-016-0202-y

 received in 2015-11-12, accepted in 2016-01-21,  发布年份 2016

【 摘 要 】

Background

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.

Methods

Databases 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.

Results

Twelve 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.

Conclusions

The 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.

【 授权许可】

   
2016 Li et al.

【 图 表 】

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