The Comparison of Manual and Mechanical Chest Compression on Survival and Long-Term Neurological Outcome of Nontraumatic Out-of-Hospital Cardiac Arrest Patients

Abstract

Background: High-quality chest compressions are an important determinant for favorable neurological outcome. Associations of long-term mortality and neurological outcomes with chest compression types still require investigation.

Objectives: This study aimed to evaluate 'mechanical or manual CPR' provided in the emergency department after manual cardiopulmonary resuscitation (CPR) initiated in prehospital settings until admission. Efficacy of chest compression types on survival and favorable neurological outcomes were compared in out-of-hospital cardiac arrest (OHCA) patients.

Methods: A total of 818 nontraumatic OHCA patients were evaluated (345 in the manual CPR group and 473 in the mechanical CPR group) retrospectively. One-year survival with a modified Rankin scale (mRS) ≤ 3 was accepted as a favorable neurological outcome.

Results: There was no significant difference between the CPR methods (mechanical CPR vs. manual CPR) in terms of mortality at 1, 3, 6, and 12 months (p = 0.353, p = 0.660, p = 0.679, p = 0.034, respectively). mRS ≤ 3, which was accepted as a favorable neurological status, was found to be 12 (3.5%) and 19 (4%) for the manual CPR and mechanical CPR groups, respectively (p = 0.501).

Conclusion: Comparisons of mechanical and manual chest compressions in terms of survival rates and favorable neurological outcomes showed no significant differences. Further investigation of long-term neurological outcomes with mechanical CPR utilization is required.

Keywords: cardiopulmonary resuscitation; favorable neurological outcome; manual chest compressions; mechanical chest compression device; out-of-hospital cardiac arrest.