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Meta-Analysis
. 2015 Oct 27:5:15635.
doi: 10.1038/srep15635.

Mechanical versus manual chest compressions for out-of-hospital cardiac arrest: a meta-analysis of randomized controlled trials

Lu Tang  1 , Wan-Jie Gu  2 , Fei Wang  1
Affiliations
Meta-Analysis

Mechanical versus manual chest compressions for out-of-hospital cardiac arrest: a meta-analysis of randomized controlled trials

Lu Tang et al. Sci Rep. .

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; I(2) = 65%), return of spontaneous circulation (RR 1.02, 95% CI 0.95-1.09, P = 0.59; I(2) = 0%), or long-term (≥6 months) survival (RR 0.96, 95% CI 0.79-1.16, P = 0.65; I(2) = 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; I(2) = 0%) and to hospital discharge (RR 0.88, 95% CI 0.78-0.99, P = 0.03; I(2) = 0%). Based on the current evidence, widespread use of mechanical devices for chest compressions in OHCA cannot be recommended.

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Figures

Figure 1
Figure 1
Selection of RCTs for the meta-analysis. RCT, randomized controlled trial.
Figure 2
Figure 2. Risk of bias summary.
Figure 3
Figure 3. Forest plot of the effect of mechanical versus manual chest compressions on survival with good neurological outcome to hospital discharge.
Figure 4
Figure 4. Forest plot of the effect of mechanical versus manual chest compressions on survival to hospital admission.
Figure 5
Figure 5. Forest plot of the effect of mechanical versus manual chest compressions on survival to hospital discharge.
Figure 6
Figure 6
Forest plot of the effect of mechanical versus manual chest compressions on ROSC and long-term (≥6 months) survival. ROSC, return of spontaneous circulation.
See this image and copyright information in PMC

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