A meta-analysis of the resuscitative effects of mechanical and manual chest compression in out-of-hospital cardiac arrest patients

Zhu, Ni; Chen, Qi; Jiang, Zhixia; Liao, Futuan; Kou, Bujin; Tang, Hui; Zhou, Manhong

doi:10.1186/s13054-019-2389-6

Cited by 46 publications

(41 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A more recent meta-analysis confirms these results [88] and a Cochrane report from 2018 states the following: "We conclude on the balance of evidence that mechanical chest compression devices used by trained individuals are a reasonable alternative to manual chest compressions in settings where consistent, high-quality manual chest compressions are not possible or dangerous for the provider (e.g. limited rescuers available, prolonged CPR, during hypothermic cardiac arrest, in a moving ambulance, in the angiography site and during preparation for extracorporeal CPR)" [89].…”

Section: Mechanical Chest Compressionsmentioning

confidence: 58%

Passive leg raising in out-of-hospital cardiac arrest

et al. 2019

View full text Add to dashboard Cite

Background: The chances of survival after an out-of-hospital cardiac arrest (OHCA) are one in ten. The majority of survivors have no or relatively mild neurological sequelae. Interventions are time critical and well-timed management is challenging. All aspects of resuscitation in an OHCA are based on knowledge of clinically important actions and their timing in OHCA management. Randomised trials face ethical and legal barriers. The victim is unable to give informed consent and obtaining consent from a legal surrogate delays resuscitation actions. This highlights the need for observational efforts in cardiac arrest research, together with the further exploration of clinically relevant factors and their importance to survival chances in OHCA. Methods: Study I describes the importance of the number of defibrillations in OHCA and their association with survival chances. It is based on data from the Swedish Registry of Cardiopulmonary Resuscitation (SRCR). Study II describes the implementation and feasibility of a direct pathway to immediate coronary angiography after OHCA and its outcome. Patients were screened in the field by ambulance crews and referred to the catheterisation laboratory after consultation with the interventionalist. Study III examines the effect of a basic manoeuvre (passive leg-raising, PLR) in cardiopulmonary resuscitation (CPR) in an observation comparing PLR with standard CPR. Study IV determines the association between ambulance response time and survival after an OHCA, based on data reported to the SRCR. Results: Study I: Between 1990 and 2015, 19,519 patients with a shockable rhythm were reported to the SRCR and included in the study. The chances of survival decreased as the number of defibrillations required increased. Among patients found in a shockable rhythm, 7.5% required more than 10 shocks. Among the witnessed cases, we identified 12 factors associated with survival to 30 days, one of which was the number of shocks that were delivered. Study II: Prehospital screening identified 86 OHCA patients, but only 58% fulfilled the given criteria for pathway activation. Among these, the angiography procedure was started within an hour after collapse in half the cases and the majority had a culprit lesion. Thirty per cent of the patients survived to 30 days and 92% of the survivors presented with a shockable rhythm. All survivors had a good cerebral performance or sufficient function to manage activities of daily life independently. Study III: The PLR manoeuvre was performed in 44% of the n=3,554 OHCA patients included in the study. Survival to 30 days was 7.9% among patients who received PLR and 13.5% among those who did not (OR 0.55; 95% CI 0.44-0.69; p < 0.0001). When matching 1:1 on a propensity score, the difference in 30-day survival between the two groups disappeared (OR 1.07; CI 0.80-1.44; p = 0.65). The matched comparison showed a 30-day survival rate of 8.6% in the PLR group versus 8.2% in the control group. Study IV: Survival chances after a witnessed OHCA decreased as ambulance respo...

show abstract

Section: Mechanical Chest Compressionsmentioning

confidence: 58%

Passive leg raising in out-of-hospital cardiac arrest

et al. 2019

View full text Add to dashboard Cite

show abstract

“…[5][6][7] A meta-analysis of continuous cardiopulmonary resuscitation by manual compression devices likewise found no survival benefit. 8 Thus, we believe that the argument of shorter pause time does not provide significant justification by itself for the superiority of TEE.…”

Section: To Tee or Not To Tee? That Is The Questionmentioning

confidence: 89%

To TEE or Not to TEE? That Is the Question

Ehrman

Favot

Hartley

et al. 2019

Annals of Emergency Medicine

View full text Add to dashboard Cite

“…Another parameter, apart from the depth of chest compressions, influencing the quality of chest compression is the CC rate per minute. The chest compression rate was also associated with the return of spontaneous circulation [19,20]. CPR guidelines performer by AHA as well as ERC recommends that the CPR be greater than 100CPM, but not greater than 120CPM [21,22].…”

Section: Discussionmentioning

confidence: 99%

Comparison of different chest compression positions for use while wearing CBRN-PPE: a randomized crossover simulation trial

Małysz¹,

Jaguszewski

Szarpak

et al. 2020

Disaster Emerg Med J

View full text Add to dashboard Cite

INTRODUCTION: The prevailing COVID-19 pandemic forces paramedics to take medical rescue operations using personal protective equipment (PPE) for aerosol-generating procedures (AGP). The use of PPE-AGP may reduce the effectiveness of the procedures performed, including airway management, intravascular access, or chest compression. The goal of the current study was to compare the quality by which a chest compression during simulated COVID-19 resuscitation while wearing PPE-AGP. A secondary goal was to assess provider preferences with standard versus OHD chest compression methods while wearing PPE-AGP. MeThODS: This is a randomized cross-over single-blinded study involving 37 paramedics performing 2-min continuous chest compression using two methods: the standard chest compression (CC) method during which the rescuer takes a position to the side of the victim (STD) and over-the-head position (OHD). During cardiopulmonary resuscitation, study participants wore Class C PPE-AGP. Both the order of study participants and compression methods were random. The results were blinded before statistical analysis. The compression rate per minute (CPM), CC depth as well as full chest recoil were measured. The analysis was undertaken using STATISTICA (V13.3EN). ReSULTS: Mean chest compression depth using distinct CC methods varied and amounted to 42 ± 2mm for STD vs. 46 ± 4mm for OHD (p < 0.001). Chest compressions based on the OHD method were associated with a lower frequency of chest compressions (107 ± 7CPM) compared with STD (114.5 ± 8; p< 0.001). A higher percentage of full chest recoil was observed in the case of STD (42 ± 6%) than in the case of OHD (34 ± 10%). CONCLUSIONS: Based on the current simulation trial, it is impossible to clearly determine which method (STD vs. OHD) is more effective in resuscitation with PPE-AGP. Paramedics wearing PPE-AGP achieved better chest compression depth for OHD compared to the STD, however, OHD resuscitation causes a lower degree of full chest relaxation. A further well-designed clinical study looking at efficacy, safety, and outcomes is needed to confirm current results.

show abstract

A meta-analysis of the resuscitative effects of mechanical and manual chest compression in out-of-hospital cardiac arrest patients

Cited by 46 publications

References 30 publications

Passive leg raising in out-of-hospital cardiac arrest

Passive leg raising in out-of-hospital cardiac arrest

To TEE or Not to TEE? That Is the Question

Comparison of different chest compression positions for use while wearing CBRN-PPE: a randomized crossover simulation trial

Contact Info

Product

Resources

About