Comparison of Manual Chest Compression Versus Mechanical Chest Compression for Out-of-hospital Cardiac Arrest: A Systematic Review and Meta-analysis

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2024 Feb 23

PMID 38394534

Authors

Muhammad Omar Larik

Ayesha Ahmed

Moeez Ibrahim Shiraz

Seemin Afshan Shiraz

Muhammad Umair Anjum

Pratik Bhattarai

Affiliations

Soon will be listed here.

Abstract

Background: Out-of-hospital cardiac arrest is a life-threatening condition that requires immediate intervention to increase the prospect of survival. There are various ways to achieve cardiopulmonary resuscitation in such patients, either through manual chest compression or mechanical chest compression. Thus, we performed a systematic review and meta-analysis to investigate the differences between these interventions.

Methods: PubMed, Cochrane Library, and Scopus were explored from inception to May 2023. Additionally, the bibliographies of relevant studies were searched. The Cochrane Risk of Bias Tool for Randomized Controlled Trials, Newcastle-Ottawa Scale, and the Risk of Bias in Non-Randomized Studies-I tools were utilized to perform quality and risk of bias assessments.

Results: There were 24 studies included within this quantitative synthesis, featuring a total of 111,681 cardiac arrest patients. Overall, no statistically significant differences were observed between the return of spontaneous circulation, survival to hospital discharge, short-term survival, and long-term survival. However, manual chest compression was associated with a significantly superior favorability of neurological outcomes (OR: 1.41; 95% CI: 1.07, 1.84; P = .01).

Conclusion: Although there were no major differences between the strategies, the poorer post-resuscitation neurological outcomes observed in mechanical chest compression indicate the need for further innovation and advancements within the current array of mechanical devices. However, future high-quality studies are necessary in order to arrive at a valid conclusion.

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References

Ong M, Ornato J, Edwards D, Dhindsa H, Best A, Ines C . Use of an automated, load-distributing band chest compression device for out-of-hospital cardiac arrest resuscitation. JAMA. 2006; 295(22):2629-37. DOI: 10.1001/jama.295.22.2629. View

Casner M, Andersen D, Isaacs S . The impact of a new CPR assist device on rate of return of spontaneous circulation in out-of-hospital cardiac arrest. Prehosp Emerg Care. 2005; 9(1):61-7. DOI: 10.1080/10903120590891714. View

Wik L, Olsen J, Persse D, Sterz F, Lozano Jr M, Brouwer M . Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial. Resuscitation. 2014; 85(6):741-8. DOI: 10.1016/j.resuscitation.2014.03.005. View

. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2005; 112(24 Suppl):IV1-203. DOI: 10.1161/CIRCULATIONAHA.105.166550. View

Newberry R, Redman T, Ross E, Ely R, Saidler C, Arana A . No Benefit in Neurologic Outcomes of Survivors of Out-of-Hospital Cardiac Arrest with Mechanical Compression Device. Prehosp Emerg Care. 2018; 22(3):338-344. DOI: 10.1080/10903127.2017.1394405. View

Berg R, Hemphill R, Abella B, Aufderheide T, Cave D, Fran Hazinski M . Part 5: adult basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010; 122(18 Suppl 3):S685-705. DOI: 10.1161/CIRCULATIONAHA.110.970939. View

Perkins G, Lall R, Quinn T, Deakin C, Cooke M, Horton J . Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. Lancet. 2014; 385(9972):947-55. DOI: 10.1016/S0140-6736(14)61886-9. View

Tantarattanapong S, Chantaramanee K . Comparison of Sustained Return of Spontaneous Circulation Rate Between Manual and Mechanical Chest Compression in Adult Cardiac Arrest. Open Access Emerg Med. 2022; 14:599-608. PMC: 9637349. DOI: 10.2147/OAEM.S373669. View

Buckler D, Burke R, Naim M, MacPherson A, Bradley R, Abella B . Association of Mechanical Cardiopulmonary Resuscitation Device Use With Cardiac Arrest Outcomes: A Population-Based Study Using the CARES Registry (Cardiac Arrest Registry to Enhance Survival). Circulation. 2016; 134(25):2131-2133. DOI: 10.1161/CIRCULATIONAHA.116.026053. View

10.

Axelsson C, Nestin J, Svensson L, Axelsson A, Herlitz J . Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of out-of-hospital cardiac arrest-a pilot study. Resuscitation. 2006; 71(1):47-55. DOI: 10.1016/j.resuscitation.2006.02.011. View

11.

Smekal D, Johansson J, Huzevka T, Rubertsson S . A pilot study of mechanical chest compressions with the LUCAS™ device in cardiopulmonary resuscitation. Resuscitation. 2011; 82(6):702-6. DOI: 10.1016/j.resuscitation.2011.01.032. View

12.

Gonzales L, Oyler B, Hayes J, Escott M, Cabanas J, Hinchey P . Out-of-hospital cardiac arrest outcomes with "pit crew" resuscitation and scripted initiation of mechanical CPR. Am J Emerg Med. 2018; 37(5):913-920. DOI: 10.1016/j.ajem.2018.08.031. View

13.

Satterlee P, Boland L, Johnson P, Hagstrom S, Page D, Lick C . Implementation of a mechanical chest compression device as standard equipment in a large metropolitan ambulance service. J Emerg Med. 2013; 45(4):562-9. DOI: 10.1016/j.jemermed.2013.04.012. View

14.

Mastenbrook J, Redinger K, Vos D, Dickson C . Retrospective Comparison of Prehospital Sustained Return of Spontaneous Circulation (ROSC) Rates Within a Single Basic Life Support Jurisdiction Using Manual vs Lund University Cardiac Assist System (LUCAS-2) Mechanical Cardiopulmonary Resuscitation. Cureus. 2022; 14(6):e26131. PMC: 9298685. DOI: 10.7759/cureus.26131. View

15.

Mistraletti G, Lancioni A, Bassi G, Nespoli F, Umbrello M, Salini S . Mechanical chest compression and extracorporeal life support for out-of-hospital cardiac arrest. A 30-month observational study in the metropolitan area of Milan, Italy. Resuscitation. 2022; 182:109659. DOI: 10.1016/j.resuscitation.2022.11.025. View

16.

Rubertsson S, Lindgren E, Smekal D, Ostlund O, Silfverstolpe J, Lichtveld R . Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial. JAMA. 2013; 311(1):53-61. DOI: 10.1001/jama.2013.282538. View

17.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

18.

Yannopoulos D, McKnite S, Aufderheide T, Sigurdsson G, Pirrallo R, Benditt D . Effects of incomplete chest wall decompression during cardiopulmonary resuscitation on coronary and cerebral perfusion pressures in a porcine model of cardiac arrest. Resuscitation. 2005; 64(3):363-72. DOI: 10.1016/j.resuscitation.2004.10.009. View

19.

Zhu N, Chen Q, Jiang Z, Liao F, Kou B, Tang H . A meta-analysis of the resuscitative effects of mechanical and manual chest compression in out-of-hospital cardiac arrest patients. Crit Care. 2019; 23(1):100. PMC: 6437862. DOI: 10.1186/s13054-019-2389-6. View

20.

Lin C, Huang M, Feng Y, Jeng W, Chung T, Lau Y . Effectiveness of mechanical chest compression for out-of-hospital cardiac arrest patients in an emergency department. J Chin Med Assoc. 2015; 78(6):360-3. DOI: 10.1016/j.jcma.2015.01.005. View