Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
Critical Care
Published in: Critical Care 1/2019

Open Access 01-12-2019 | Cardiopulmonary Resuscitation | Research

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

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

Published in: Critical Care | Issue 1/2019

Login to get access

Abstract

Objectives

To evaluate the resuscitative effects of mechanical and manual chest compression in patients with out-of-hospital cardiac arrest (OHCA).

Methods

All randomized controlled and cohort studies comparing the effects of mechanical compression and manual compression on cardiopulmonary resuscitation in OHCA patients were retrieved from the Cochrane Library, PubMed, EMBASE, and Ovid databases from the date of their establishment to January 14, 2019. The included outcomes were as follows: the return of spontaneous circulation (ROSC) rate, the rate of survival to hospital admission, the rate of survival to hospital discharge, and neurological function. After evaluating the quality of the studies and summarizing the results, RevMan5.3 software was used for the meta-analysis.

Results

In total, 15 studies (9 randomized controlled trials and 6 cohort studies) were included. The results of the meta-analysis showed that there were no significant differences in the resuscitative effects of mechanical and manual chest compression in terms of the ROSC rate, the rate of survival to hospital admission and survival to hospital discharge, and neurological function in OHCA patients (ROSC: RCT: OR = 1.12, 95% CI (0.90, 1.39), P = 0.31; cohort study: OR = 1.08, 95% CI (0.85, 1.36), P = 0.54; survival to hospital admission: RCT: OR = 0.95, 95% CI (0.75, 1.20), P = 0.64; cohort study: OR = 0.98 95% CI (0.79, 1.20), P = 0.82; survival to hospital discharge: RCT: OR = 0.87, 95% CI (0.68, 1.10), P = 0.24; cohort study: OR = 0.78, 95% CI (0.53, 1.16), P = 0.22; Cerebral Performance Category (CPC) score: RCT: OR = 0.88, 95% CI (0.64, 1.20), P = 0.41; cohort study: OR = 0.68, 95% CI (0.34, 1.37), P = 0.28). When the mechanical compression group was divided into Lucas and Autopulse subgroups, the Lucas subgroup showed no difference from the manual compression group in ROSC, survival to admission, survival to discharge, and CPC scores; the Autopulse subgroup showed no difference from the manual compression subgroup in ROSC, survival to discharge, and CPC scores.

Conclusion

There were no significant differences in resuscitative effects between mechanical and manual chest compression in OHCA patients. To ensure the quality of CPR, we suggest that manual chest compression be applied in the early stage of CPR for OHCA patients, while mechanical compression can be used as part of advanced life support in the late stage.
Literature
1.
Idris AH, Guffey D, Pepe PP, et al. Chest compression rates and survival following out-of-hospital cardiac arrest. Crit Care Med. 2015;43(4):840–8.CrossRef
2.
Stiell IG, Brown SP, Christenson J, et al. What is the role of chest compression depth during out-of-hospital cardiac arrest resuscitation? Crit Care Med. 2012;40:1192–8.5.CrossRef
3.
Kouw Kleinman ME, Brennan EE, Goldberger ZD, et al. Part 5: adult basic life support and cardiopulmonary resuscitation quality: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S414–435.64–1067.CrossRef
4.
Hightower D, Thomas SH, Stone CK, Dunn K, March JA. Decay in quality of closed-chest compressions over time. Ann Emerg Med. 1995;26(3):300–3.CrossRef
5.
Lurie K. Mechanical devices for cardiopulmonary resuscitation: an update. Emerg Med Clin North Am. 2002;20(4):771–84.CrossRef
6.
Ikeno F, Kaneda H, Hongo Y, Sakanoue Y, Nolasco C, Emami S, et al. Augmentation of tissue perfusion by a novel compression device increases neurological intact survival in porcine model of prolonged cardiac arrest. Resuscitation. 2006;68:109–18.CrossRef
7.
Halperin H, Paradis N, Ornato J. Cardiopulmonary resuscitation with a novel chest compression device in a porcine model of cardiac arrest: improved hemodynamics and mechanisms. J Am Coll Cardiol. 2004;44:2214–20.CrossRef
8.
Casner M, Andersen D, Isaacs SM. 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;9:61–7.CrossRef
9.
Westfall M, Krantz S, Mullin C, Kaufman C. Mechanical versus manual chest compressions in out-of-hospital cardiac arrest: a meta-analysis. Crit Care Med. 2013;41(7):1782–9.CrossRef
10.
Ong ME, Mackey KE, Zhang ZC, Tanaka H, Ma MH, Swor R. Mechanical CPR devices compared to manual CPR during out-of-hospital cardiac arrest and ambulance transport: a systematic review. Scand J Trauma Resusc Emerg Med. 2012;20:39.CrossRef
11.
Brooks SC, Hassan N, Bigham BL, Morrison LJ. Mechanical versus manual chest compressions for cardiac arrest. Cochrane Database Syst Rev. 2014;2:CD007260.
12.
Li H, Wang D, Yu Y, Zhao X, Jing X. Mechanical versus manual chest compressions for cardiac arrest: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med. 2016;24:10.CrossRef
13.
Khan SU, Lone AN, Talluri S, Khan MZ, Khan MU, Kaluski E. Efficacy and safety of mechanical versus manual compression in cardiac arrest - A Bayesian network meta-analysis. Resuscitation. 2018;130:182–8.
14.
Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration; 2011. Available from www.​handbook.​cochrane.​org.
15.
Dickinson ET, Verdile VP, Schneider RM, Salluzzo RF. Effectiveness of mechanical versus manual chest compressions in out-of-hospital cardiac arrest resuscitation: a pilot study. Am J Emerg Med. 1998;16(3):289–92.CrossRef
16.
Hallstrom A, Rea TD, Sayre MR, Christenson J, Anton AR, Mosesso VN Jr. Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial. J Am Med Assoc. 2006;H295(22):2620–8.
17.
Smekal D, Johansson J, Huzevka T, Rubertsson S. A pilot study of mechanical chest compressions with the LUCASTM device in cardiopulmonary resuscitation. Resuscitation. 2011;82(6):702–6.CrossRef
18.
Axelsson C, Nestin J, Svensson L, Axelsson AB, 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.CrossRef
19.
Hock Ong ME, Fook-Chong S, Annathurai A, Ang SH, Tiah L, Yong KL. Improved neurologically intact survival with the use of an automated, load distributing band chest compression device for cardiac arrest presenting to the emergency department. Crit Care. 2012;16:R144.CrossRef
20.
Zeiner S, Sulzgruber P, Datler P, Keferbock M, Poppe M, Lobmeyr E, van Tulder R, Zajicek A, Buchinger A, Polz K, Schrattenbacher G, Sterz F. Chest compression does not seem to improve outcome after out-of hospital cardiac arrest. A single center observational trial. Resuscitation. 2015;96:220–5.CrossRef
21.
Rubertsson S, Lindgren E, Smekal D, Östlund O, Silfverstolpe J, Lichtveld RA, Boomars R, Ahlstedt B, Skoog G, Kastberg R, Halliwell D, Box M, Herlitz J, Karlsten R. Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest. J Am Med Assoc. 2014;311(1):53–61.CrossRef
22.
Perkins GD, Lall R, Quinn T, Deakin CD, Cooke MW, Horton J, Lamb SE, Slowther AM, Woollard M, Carson A, Smyth M, Whitfield R, Williams A, Pocock H, Black JJ, Wright J, Han K, Gates S. Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. Lancet. 2015;385:947–55.CrossRef
23.
Gao C, Chen Y, Peng H, Chen Y, Zhuang Y, Zhou S. Clinical evaluation of the AutoPulse automated chest compression device for out-of-hospital cardiac arrest in the northern district of Shanghai, China. Arch Med Sci. 2016;12(3):563–70.CrossRef
24.
Wik L, Olsen JA, Persse D, Sterz F, Lozano M, Brouwer MA, Westfall M, Souders CM, Malzer R, Grunsven PM, Travis DT, Whitehead A, Herken UR, Lerner EB. Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial. Resuscitation. 2014;85:741–8.CrossRef
25.
Anantharaman V, Ng BL, Ang SH, Lee CY, Leong SH, Ong ME, Chua SJ, Rabind AC, Anjali NB, Hao Y. Prompt use of mechanical cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the MECCA study report. Singap Med J. 2017;58:424–31.CrossRef
26.
Hardig B, Lindgren E, Östlund O, Herlitz J, Karlsten R, Rubertsson S. Outcome among VF/VT patients in the LINC (LUCAS IN cardiac arrest) trial-a randomised, controlled trial. Resuscitation. 2017;115:155–62.CrossRef
27.
Ck L, et al. Effectiveness of mechanical chest compression for out-of-hospital cardiac arrest patients in an emergency department. Journal of the Chinese Medical Association. 2015;78(6):360–3.CrossRef
28.
Buckler DG, Burke RV, Naim MY, et al. 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):2131–3.CrossRef
29.
Hayashida K, Tagami T, Fukuda T, et al. Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out-of-Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS-KANTO [Survey of Survivors after Out-of-Hospital Cardiac Arrest in Kanto Area] 2012 Study). J Am Heart Assoc. 2017;31;6(11).
30.
Aufderheide TP. Incomplete chest wall decompression: a clinical evaluation of CPR performance by EMS personnel and assessment of alternative manual chest compression-decompression techniques. Resuscitation. 2005;64(3):353–62.CrossRef
Metadata
Title
A meta-analysis of the resuscitative effects of mechanical and manual chest compression in out-of-hospital cardiac arrest patients
Authors
Ni Zhu
Qi Chen
Zhixia Jiang
Futuan Liao
Bujin Kou
Hui Tang
Manhong Zhou
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2019
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-019-2389-6

Other articles of this Issue 1/2019

Critical Care 1/2019 Go to the issue

Review

Mechanical ventilation in patients with acute ischaemic stroke: from pathophysiology to clinical practice

Letter

Influence of pathogen and focus of infection on procalcitonin values in sepsis: are there additional confounding factors?

Research

Mottling score is a strong predictor of 14-day mortality in septic patients whatever vasopressor doses and other tissue perfusion parameters

Research

Interventions aimed at healthcare professionals to increase the number of organ donors: a systematic review

Research

Effects of inspiratory flow on lung stress, pendelluft, and ventilation heterogeneity in ARDS: a physiological study

Research

Organizational factors associated with target sedation on the first 48 h of mechanical ventilation: an analysis of checklist-ICU database