The Use of Mechanical Cardiopulmonary Resuscitation May Be Associated With Improved Outcomes Over Manual Cardiopulmonary Resuscitation During Inhospital Cardiac Arrests

Abstract

Objectives: We aimed to investigate the impact of mechanical cardiopulmonary resuscitation devices over manual cardiopulmonary resuscitation on outcomes from inhospital cardiac arrests. Design: Restrospective review. Setting: Single academic medical center. Participants: Data were collected on all patients who suffered cardiac arrest from December 2015 to November 2019. Main Outcomes and Measures: Primary end point was return of spontaneous circulation. Secondary end points included survival to discharge and survival to discharge with favorable neurologic outcomes. Results: About 104 patients were included in the study: 59 patients received mechanical cardiopulmonary resuscitation and 45 patients received manual cardiopulmonary resuscitation during the enrollment period. Return of spontaneous circulation rate was 83% in the mechanical cardiopulmonary resuscitation group versus 48.8% in the manual group (p = 0.009). Survival-to-discharge rate was 32.2% in the mechanical cardiopulmonary resuscitation group versus 11.1% in those who received manual cardiopulmonary resuscitation (p = 0.02). Of the patients who survived to discharge and received mechanical cardiopulmonary resuscitation, 100% (n = 19) had a favorable neurologic outcome versus 40% (two out of five) of patients who survived and received manual cardiopulmonary resuscitation (p = 0.005). Conclusions: Our findings demonstrate a significant association of improved outcomes with mechanical cardiopulmonary resuscitation over manual cardiopulmonary resuscitation during inhospital cardiac arrests. Mechanical cardiopulmonary resuscitation may improve rates of return of spontaneous circulation, survival to discharge, and favorable neurologic outcomes.

Comparison between automated cardiopulmonary resuscitation and manual cardiopulmonary resuscitation in the rescue of cardiac and respiratory arrest

“…As per the previous study, 17 the ROSC rate of A-CPR and M-CPR were 83% and 48.8%, respectively. Based on two-tailed test and assuming power set at 0.9, and variable missing as 10%, at least 40 cases would be needed for the study 18 .…”

“…Studies have shown that A-CPR was superior to M-CPR. 8 , 17 , 19 However, a meta-analysis of nine prospective studies has suggested that mechanical CPR was inferior to manual CPR in terms of attaining ROSC, and no differences in survival to discharge for in-hospital cardiac arrest patients. 11 Khan et al also reported that manual CPR is more effective in improving hospital discharge or survival at 30 days compared with mechanical CPR.…”

Rapid response system adaptations at 40 US hospitals during the COVID-19 pandemic

“…Crowd size has frequently been identified as a barrier to effective team functioning and, although it is best studied in out-of-hospital cardiac arrest, mechanical CPR has been associated with improved survival after IHCA. 8 , 9 , 10 , 11 More studies will be required to evaluate the consequences, intended and unintended, on changes made to the structure and function of IHCA and RRT teams during the COVID-19 pandemic.…”