Effectiveness of different compression-to-ventilation methods for cardiopulmonary resuscitation: A systematic review

RESUSCITATION

卷:118

Review

Ashoor, Huda M.¹  Lillie, Erin¹  Zarin, Wasifa¹  Pham, Ba'^1,2,3  Khan, Paul A.¹  Nincic, Vera¹  Yazdi, Fatemeh¹  Ghassemi, Marco¹  Ivory, John¹  Cardoso, Roberta¹  Perkins, Gavin D.⁴  de Caen, Allan R.⁵  Tricco, Andrea C.^1,6 

[1] St Michaels Hosp, Li Ka Shing Knowledge Inst, 209 Victoria St, Toronto, ON M5B 1W8, Canada

[2] Univ Toronto, Fac Pharm, Toronto Hlth Econ & Technol Assessment Collaborat, 144 Coll St, Toronto, ON M5S 3M2, Canada

[3] Univ Toronto, Inst Hlth Policy Management Evaluat, 144 Coll St, Toronto, ON M5S 3M2, Canada

[4] Univ Warwick, NHS Fdn Trust, Warwick Med Sch & Heart England, Coventry CV4 7AL, W Midlands, England

[5] Univ Alberta, Stollery Childrens Hosp, 8440 112 St Northwest, Edmonton, AB T6G 2B7, Canada

[6] Univ Toronto, Dalla Lana Sch Publ Hlth, Epidemiol Div, Hlth Sci Bldg,155 Coll St,6th floor, Toronto, ON M5T 3M7, Canada

关键词: Cardiac arrest;    Cardiopulmonary resuscitation;    Ventilation;    Chest compression;    Bystander CPR;    Functional neurological outcome;    Survival;    Rate of Return to Spontaneous Circulation;    ROSC;    Quality of life;   

DOI  :  10.1016/j.resuscitation.2017.05.032

来源: Elsevier

【 摘 要 】

Aim: To compare the effectiveness of different compression-to-ventilation methods during cardiopulmonary resuscitation (CPR) in patients with cardiac arrest. Methods: We searched MEDLINE and Cochrane Central Register of Controlled Trials from inception until January 2016. We included experimental, quasi-experimental, and observational studies that compared different chest compression-to-ventilation ratios during CPR for all patients and assessed at least one of the following outcomes: favourable neurological outcomes, survival, return of spontaneous circulation (ROSC), and quality of life. Two reviewers independently screened literature search results, abstracted data, and appraised the risk of bias. Random-effects meta-analyses were conducted separately for randomised and non-randomised studies, as well as study characteristics, such as CPR provider. Results: After screening 5703 titles and abstracts and 229 full-text articles, we included 41 studies, of which 13 were companion reports. For adults receiving bystander or dispatcher-instructed CPR, no significant differences were observed across all comparisons and outcomes. Significantly less adults receiving bystander-initiated or plus dispatcher-instructed compression-only CPR experienced favourable neurological outcomes, survival, and ROSC compared to CPR 30: 2 (compression-to-ventilation) in un-adjusted analyses in a large cohort study. Evidence from emergency medical service (EMS) CPR providers showed significantly more adults receiving CPR 30: 2 experiencing improved favourable neurological outcomes and survival versus those receiving CPR 15: 2. Significantly more children receiving CPR 15: 2 or 30: 2 experienced favourable neurological outcomes, survival, and greater ROSC compared to compressiononly CPR. However, for children <1 years of age, no significant differences were observed between CPR 15: 2 or 30: 2 and compression-only CPR. Conclusions: Our results demonstrated that for adults, CPR 30: 2 is associated with better survival and favourable neurological outcomes when compared to CPR 15: 2. For children, more patients receiving CPR with either 15: 2 or 30: 2 compression-to ventilation ratio experienced favourable neurological function, survival, and ROSC when compared to CO-CPR for children of all ages, but for children <1 years of age, nostatistically significant differences were observed. (C) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

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