Mechanical chest compression does not seem to improve outcome after out-of hospital cardiac arrest. A single center observational trial

Zeiner, Sebastian; Sulzgruber, Patrick; Datler, Philip; Keferböck, Markus; Poppe, Michael; Lobmeyr, Elisabeth; Tulder, Raphael van; Zajicek, Andreas; Buchinger, Angelika; Polz, Karl; Schrattenbacher, Georg; Sterz, Fritz

doi:10.1016/j.resuscitation.2015.07.051

Cited by 24 publications

(23 citation statements)

References 31 publications

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“…Mechanical chest compression devices may play a key role in maintaining CPR quality for ECPR-eligible patients that are transported to hospital. 32 However, as studies comparing the outcomes of patients treated with these high-cost devices to manual CPR have demonstrated worse 33,34 or neutral results, [35][36][37] EMS systems may lack enthusiasm to incorporate mechanical compression systems into routine management.…”

Section: Discussionmentioning

confidence: 99%

“…Of those with resuscitation for > 30 minutes, only 1.4% had favorable outcomes. 34 From a cohort of patients who were transported to hospital, of whom 10% were chosen for ECPR, Kim et al constructed a ROC curve from those not treated with ECPR and concluded the ideal time to consider ECPR was 21 min. 18 No published prospective randomized trials have compared ECPR to conventional care.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between Time-to-ROSC and Survival in Out-of-hospital Cardiac Arrest ECPR Candidates: When is the Best Time to Consider Transport to Hospital?

Grunau

Reynolds

Scheuermeyer

et al. 2016

Prehospital Emergency Care

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Relationship between Time-to-ROSC and Survival in Out-of-hospital Cardiac Arrest ECPR Candidates: When is the Best Time to Consider Transport to Hospital?

Grunau

Reynolds

Scheuermeyer

et al. 2016

Prehospital Emergency Care

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“…Observational studies provide useful insights in to the effectiveness of interventions, but are prone to biases, such as selection bias and the recently described resuscitation time bias [24, 25]. In the out-of-hospital setting, observational studies of mech-CPR have produced inconsistent findings [26–28]. In contrast, findings of high-quality large randomised controlled trials have produced consistent results, showing no benefit in the routine use of mech-CPR compared with man-CPR [10].…”

Section: Discussionmentioning

confidence: 99%

Mechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm: a randomised controlled feasibility trial (COMPRESS-RCT)

Couper

Quinn

Lall

et al. 2018

Scand J Trauma Resusc Emerg Med

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BackgroundMechanical chest compression devices consistently deliver high-quality chest compressions. Small very low-quality studies suggest mechanical devices may be effective as an alternative to manual chest compressions in the treatment of adult in-hospital cardiac arrest patients. The aim of this feasibility trial is to assess the feasibility of conducting an effectiveness trial in this patient population.MethodsCOMPRESS-RCT is a multi-centre parallel group feasibility randomised controlled trial, designed to assess the feasibility of undertaking an effectiveness to compare the effect of mechanical chest compressions with manual chest compressions on 30-day survival following in-hospital cardiac arrest.Over approximately two years, 330 adult patients who sustain an in-hospital cardiac arrest and are in a non-shockable rhythm will be randomised in a 3:1 ratio to receive ongoing treatment with a mechanical chest compression device (LUCAS 2/3, Jolife AB/Stryker, Lund, Sweden) or continued manual chest compressions. It is intended that recruitment will occur on a 24/7 basis by the clinical cardiac arrest team. The primary study outcome is the proportion of eligible participants randomised in the study during site operational recruitment hours. Participants will be enrolled using a model of deferred consent, with consent for follow-up sought from patients or their consultee in those that survive the cardiac arrest event.The trial will have an embedded qualitative study, in which we will conduct semi-structured interviews with hospital staff to explore facilitators and barriers to study recruitment.DiscussionThe findings of COMPRESS-RCT will provide important information about the deliverability of an effectiveness trial to evaluate the effect on 30-day mortality of routine use of mechanical chest compression devices in adult in-hospital cardiac arrest patients.Trial registrationISRCTN38139840, date of registration 9th January 2017.Electronic supplementary materialThe online version of this article (10.1186/s13049-018-0538-6) contains supplementary material, which is available to authorized users.

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“…Seven studies investigated use of a mechanical chest compression device (11)(12)(13)(14)(15)(16)(17). Two types of devices were found: 1) A load distributing band (LDB) design (Autopulse®); and 2) an active compression/decompression design (LUCAS).…”

Section: Use Of a Mechanical Chest Compression Devicementioning

confidence: 99%

Strategies to Improve Out-of-Hospital Cardiac Arrest Outcomes in the Pre-Hospital Environment – Part B: Non-Pharmaceutical Strategies

Pemberton¹,

Franklin²,

Watt³

2019

Australasian Journal of Paramedicine

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IntroductionOut-of-hospital cardiac arrest (OHCA) historically has low survival rates. Higher rates of survival have recently developed in some small geographical areas, which pre-empted an increase in the volume of research in this field. The aim of this paper is to consolidate the findings of the strategies that do not focus on drugs.MethodsThis is a systematic search and review, rather than a systematic review. A search of four databases (MEDLINE, CINAHL, Informit, Scopus) was undertaken in February 2017. Papers published between 2007 and 2017 containing strategies that may be used by paramedics when resuscitating adult patients in OHCA from presumed cardiac aetiology were identified.ResultsTwenty-eight studies were included in the review, comprising six separate strategies. This manuscript reports on the four non-pharmaceutical strategies (use of a modified resuscitation protocol; use of a mechanical chest compression device; intra-thoracic pressure regulation and application of therapeutic hypothermia).ConclusionUse of a modified resuscitation protocol to improve the quality of cardiopulmonary resuscitation, was the only strategy showing evidence to warrant a recommendation for immediate implementation. Future studies should focus on strategy specific patient subsets.

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Mechanical chest compression does not seem to improve outcome after out-of hospital cardiac arrest. A single center observational trial

Cited by 24 publications

References 31 publications

Relationship between Time-to-ROSC and Survival in Out-of-hospital Cardiac Arrest ECPR Candidates: When is the Best Time to Consider Transport to Hospital?

Relationship between Time-to-ROSC and Survival in Out-of-hospital Cardiac Arrest ECPR Candidates: When is the Best Time to Consider Transport to Hospital?

Mechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm: a randomised controlled feasibility trial (COMPRESS-RCT)

Strategies to Improve Out-of-Hospital Cardiac Arrest Outcomes in the Pre-Hospital Environment – Part B: Non-Pharmaceutical Strategies

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