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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Open Access 01-12-2021 | Cardiopulmonary Resuscitation | Review

Impact of dispatcher-assisted cardiopulmonary resuscitation on neurologically intact survival in out-of-hospital cardiac arrest: a systematic review

Authors: Kristine Elisabeth Eberhard, Gitte Linderoth, Mads Christian Tofte Gregers, Freddy Lippert, Fredrik Folke

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2021

Abstract

Background

Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) increases neurologically intact survival in out-of-hospital cardiac arrest (OHCA) according to several studies. This systematic review summarizes neurologically intact survival outcomes of DA-CPR in comparison with bystander-initiated CPR and no bystander CPR in OHCA.

Methods

The systematic review was conducted according to the PRISMA guidelines. All studies including adult and/or pediatric OHCAs that compared DA-CPR with bystander-initiated CPR or no bystander CPR were included. Primary outcome was neurologically intact survival at discharge, one-month or longer. Studies were searched for in PubMed (MEDLINE), EMBASE, and the Cochrane Library databases. The risk of bias was evaluated using the Newcastle-Ottawa Scale.

Results

The search string generated 4742 citations of which 33 studies were eligible for inclusion. Due to overlapping study populations, the review included 14 studies. All studies were observational. The study populations were heterogeneous and included adult, pediatric and mixed populations. Some studies reported only witnessed cardiac arrests, arrests of cardiac ethiology, and/or shockable rhythm. The individual studies scored between six and nine on the Newcastle-Ottawa Scale of risk of bias. The median neurologically intact survival at hospital discharge with DA-CPR was 7.0% (interquartile range (IQR): 5.1–10.8%), with bystander-initiated CPR 7.5% (IQR: 6.6–10.2%), and with no bystander CPR 4.4% (IQR: 2.0–9.0%) (four studies). At one-month neurologically intact survival with DA-CPR was 3.1% (IQR: 1.6–3.4%), with bystander-initiated CPR 5.7% (IQR: 5.0–6.0%), and with no bystander CPR 2.5% (IQR: 2.1–2.6%) (three studies).

Conclusion

Both DA-CPR and bystander-initiated CPR increase neurologically intact survival compared with no bystander CPR. However, DA-CPR demonstrates inferior outcomes compared with bystander-initiated CPR. Early CPR is crucial, thus in cases where bystanders have not initiated CPR, DA-CPR provides an opportunity to improve neurologically intact survival following OHCA. Variability in OHCA outcomes across studies and multiple confounding factors were identified.

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Title: Impact of dispatcher-assisted cardiopulmonary resuscitation on neurologically intact survival in out-of-hospital cardiac arrest: a systematic review
Authors: Kristine Elisabeth Eberhard
Gitte Linderoth
Mads Christian Tofte Gregers
Freddy Lippert
Fredrik Folke
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Cardiopulmonary Resuscitation
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2021
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/s13049-021-00875-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of dispatcher-assisted cardiopulmonary resuscitation on neurologically intact survival in out-of-hospital cardiac arrest: a systematic review

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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