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Meta-Analysis
. 2016 Feb 1:24:10.
doi: 10.1186/s13049-016-0202-y.

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

Hui Li  1 , Dongping Wang  2 , Yi Yu  1 , Xiang Zhao  1 , Xiaoli Jing  3
Affiliations
Meta-Analysis

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

Hui Li et al. Scand J Trauma Resusc Emerg Med. .

Abstract

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.

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Figures

Fig. 1
Fig. 1
Flow diagram of search criteria and reason for exclusion
Fig. 2
Fig. 2
Effect of manual chest compression and mechanical chest compression on ROSC for OHCA patients
Fig. 3
Fig. 3
Effect of manual chest compression and mechanical chest compression on ROSC for in-hospital CA patients
Fig. 4
Fig. 4
Effect of manual chest compression and mechanical chest compression on survival to hospital admission for OHCA patients
Fig. 5
Fig. 5
Effect of manual chest compression and mechanical chest compression on survival to hospital discharge for OHCA patients
Fig. 6
Fig. 6
Effect of manual chest compression and mechanical chest compression on survival to hospital discharge for in-hospital CA patients
Fig. 7
Fig. 7
Effect of manual chest compression and mechanical chest compression on CPC for OHCA patients
Fig. 8
Fig. 8
Funnel plot for publication bias for OHCA studies
Fig. 9
Fig. 9
Funnel plot for publication bias for in-hospital CA studies
See this image and copyright information in PMC

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References

    1. Ewy GA. Cardiocerebral resuscitation: the new cardiopulmonary resuscitation. Circulation. 2005;111(16):2134–42. doi: 10.1161/01.CIR.0000162503.57657.FA. - DOI - PubMed
    1. Kern KB, Carter AB, Showen RL, Voorhees WD, 3rd, Babbs CF, Tacker WA, et al. Twenty-four hour survival in a canine model of cardiac arrest comparing three methods of manual cardiopulmonary resuscitation. J Am Coll Cardiol. 1986;7:859–67. doi: 10.1016/S0735-1097(86)80348-5. - DOI - PubMed
    1. Maier GW, Tyson GS, Jr, Olsen CO, Kernstein KH, Davis JW, Conn EH, et al. The physiology of external cardiac massage: high-impulse cardiopulmonary resuscitation. Circulation. 1984;70:86–101. doi: 10.1161/01.CIR.70.1.86. - DOI - PubMed
    1. Swart GL, Mateer JR, DeBehnke DJ, Jameson SJ, Osborn JL. The effect of compression duration on hemodynamics during mechanical high-impulse CPR. Acad Emerg Med. 1994;1:430–7. doi: 10.1111/j.1553-2712.1994.tb02522.x. - DOI - PubMed
    1. Havel C, Schreiber W, Riedmuller E, Haugk M, Richling N, Trimmel H, et al. Quality of closed chest compression in ambulance vehicles, flying helicopters and at the scene. Resuscitation. 2007;73:264–70. doi: 10.1016/j.resuscitation.2006.09.007. - DOI - PubMed

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