Prognostic Impact of In-Hospital Use of Mechanical Cardiopulmonary Resuscitation Devices Compared with Manual Cardiopulmonary Resuscitation: A Nationwide Population-Based Observational Study in South Korea

Abstract

Background and Objectives: This study analyzed the prognostic impact of mechanical cardiopulmonary resuscitation (CPR) devices in out-of-hospital cardiac arrest (OHCA) patients, in comparison to manual CPR. Materials and Methods: This study was a nationwide population-based observational study in South Korea. Data were retrospectively collected from 142,905 OHCA patients using the South Korean Out-of-Hospital Cardiac Arrest Surveillance database. We included adult OHCA patients who received manual or mechanical CPR in the emergency room. The primary outcome was survival at discharge and the secondary outcome was sustained return of spontaneous circulation (ROSC). Statistical analysis included propensity score matching and multivariate logistic regression. Results: A total of 19,045 manual CPR and 1125 mechanical CPR cases (671 AutoPulseTM vs. 305 ThumperTM vs. 149 LUCASTM) were included. In the matched multivariate analyses, all mechanical CPR devices were associated with a lower ROSC than that of manual CPR. AutoPulseTM was associated with lower survival in the multivariate analysis after matching (aOR with 95% CI: 0.57 (0.33–0.96)), but the other mechanical CPR devices were associated with similar survival to discharge as that of manual CPR. Witnessed arrest was commonly associated with high ROSC, but the use of mechanical CPR devices and cardiac origin arrest were associated with low ROSC. Only target temperature management was the common predictor for high survival. Conclusions: The mechanical CPR devices largely led to similar survival to discharge as that of manual CPR in OHCA patients; however, the in-hospital use of the AutoPulseTM device for mechanical CPR may significantly lower survival compared to manual CPR.

Characteristics and outcomes of out‐of‐hospital cardiac arrest in a hilly area: Utstein Registry data from the Nagasaki Medical Region, Japan

“…Thus, it was important to determine the role of m‐CPR in prehospital resuscitation as it can be a powerful treatment adjunct in OHCA. 6 Some articles proved that the use of m‐CPR led to a similar survival rate as that of manual CPR, 7 , 8 , 9 but others reported negative effects of using m‐CPR devices instead of manual CPR. 10 , 11 , 12 Our multivariable logistic regression analysis showed the use of m‐CPR devices to be associated with a worse survival prognosis with good neurological outcomes: The one‐month survival rate after m‐CPR device use was 2.8%, whereas that without its use was 12.1%.…”

Use of Mechanical Chest Compression for Resuscitation in Out-Of-Hospital Cardiac Arrest—Device Matters: A Propensity-Score-Based Match Analysis

“…As outlined before, this study, different from the majority of previous studies on this topic, provided a comparison of three different devices, exploring their impact both on ROSC and on 30-day survival. This was a valuable point because there was only one paper [ 13 ] that considered three devices; however, no direct comparison was provided. Moreover, in that paper, two piston-driven machines and one load-distributing-band device were considered, whereas we compared a load-distributing-band device, a piston-driven device, and a combined band and piston device.…”

“…Randomized controlled trials [ 7 , 8 , 9 , 10 , 11 , 12 ], observational studies [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ], and meta-analyses [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ] have been carried out trying to assess the effect of these devices on the return of a spontaneous circulation (ROSC) and on OHCA patients’ survival, but they led to conflicting results. Moreover, Autopulse ® and LUCAS ® were the most studied but, once again, very little evidence is available for other devices such as EASY PULSE ® [ 31 , 32 ].…”

Return of spontaneous circulation (ROSC) dengan menggunakan resusitasi jantung paru (RJP) mekanik dan manual: A literature review

“…Di Inggris, resusitasi mekanis lebih efektif dalam menyelamatkan pasien dengan henti jantung dengan ROSC sebesar 27.6% dengan jumlah 36 pasien masih hidup selama 30 hari dibandingkan kompresi manual, hal ini dikarenakan pengaplikasian perangkat mekanis membutuhkan waktu yang lebih lama, selain itu mekanisme kedalaman kompresi, kecepatan dan dekompresi yang digunakan oleh mesin berbeda beda sehingga memberikan hasil yang kurang optimal dari perangkat mekanis tersebut (Kim et al, 2022).…”