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. 2021 Nov 26:8:733724.
doi: 10.3389/fmed.2021.733724. eCollection 2021.

Influence of Personal Protective Equipment on the Quality of Chest Compressions: A Meta-Analysis of Randomized Controlled Trials

Ying Cui  1 , Siyi Jiang  1
Affiliations

Influence of Personal Protective Equipment on the Quality of Chest Compressions: A Meta-Analysis of Randomized Controlled Trials

Ying Cui et al. Front Med (Lausanne). .

Abstract

Background: Randomized controlled trials (RCTs) evaluating the influence of personal protective equipment (PPE) on quality of chest compressions during cardiopulmonary resuscitation (CPR) showed inconsistent results. Accordingly, a meta-analysis was performed to provide an overview. Methods: Relevant studies were obtained by search of Medline, Embase, and Cochrane's Library databases. A random-effect model incorporating the potential heterogeneity was used to pool the results. Results: Six simulation-based RCTs were included. Overall, pooled results showed that there was no statistically significant difference between the rate [mean difference (MD): -1.70 time/min, 95% confidence interval (CI): -5.77 to 2.36, P = 0.41, I 2 = 80%] or the depth [MD: -1.84 mm, 95% CI: -3.93 to 0.24, P = 0.11, I 2 = 73%] of chest compressions performed by medical personnel with and without PPE. Subgroup analyses showed that use of PPE was associated with reduced rate of chest compressions in studies before COVID-19 (MD: -7.02 time/min, 95% CI: -10.46 to -3.57, P < 0.001), but not in studies after COVID-19 (MD: 0.14 time/min, 95% CI: -5.77 to 2.36, P = 0.95). In addition, PPE was not associated with significantly reduced depth of chest compressions in studies before (MD: -3.34 mm, 95% CI: -10.29 to -3.62, P = 0.35) or after (MD: -0.97 mm, 95% CI: -2.62 to 0.68, P = 0.25) COVID-19. No significant difference was found between parallel-group and crossover RCTs (P for subgroup difference both > 0.05). Conclusions: Evidence from simulation-based RCTs showed that use of PPE was not associated with reduced rate or depth of chest compressions in CPR.

Keywords: cardiopulmonary resuscitation; chest compressions; meta-analysis; personal protective equipment; randomized controlled trial; simulation studies.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of literature search.
Figure 2
Figure 2
Forest plots for the meta-analysis of the quality of chest compression in medical personnel with and without PPE. (A) Forest plots for the meta-analysis of the rate of chest compression in studies before or after COVID-19 and (B) forest plots for the meta-analysis the depth of chest compression in studies before or after COVID-19.
Figure 3
Figure 3
Forest plots for the meta-analysis of the quality of chest compression in medical personnel with and without PPE. (A) Forest plots for the meta-analysis of the rate of chest compression in parallel group (PG) or crossover (CO) RCTs and (B) forest plots for the meta-analysis the depth of chest compression in parallel group PG or CO RCTs.
Figure 4
Figure 4
Funnel plots for the meta-analysis of the quality of chest compression in medical personnel with and without PPE. (A) Funnel plots for the outcome of the rate of chest compression and (B) funnel plots for the outcome of the depth of chest compression.
See this image and copyright information in PMC

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