Chen-lu Yang1, Jin Wen, You-ping Li, Ying-kang Shi. 1. West China Medical School, Sichuan University, Department of Hospital Management & Health Policy, West China Hospital, Guoxue Xiang, Chengdu 610041, China.
Abstract
OBJECTIVE: The objective of this study is to evaluate the efficacy of cardiocerebral resuscitation (CCR) vs cardiopulmonary resuscitation (CPR) for patients with out-of-hospital cardiac arrest (OHCA). METHODS: We conducted a systematic review of controlled trials and observational studies. We searched Cochrane Central Register of Controlled Trials; MEDLINE; Embase; and Chinese databases such as VIP, CNKI, WANFANG, and CBM from their inception to September 2010. Data from original studies were extracted and assessed with predefined criteria. RESULTS: Thirteen studies comprising 3 randomized controlled trials and 10 observational studies were included. Pooled analysis of 4 observational studies suggested that neurologically intact survival of patients with OHCA was improved in CCR group (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.07-1.97). Survival to hospital discharge in the CCR group was superior or at least equal to that in CPR group (randomized controlled trial OR, 1.25; 95% CI, 1.01-1.55; cohort studies OR, 1.15; 95% CI, 0.72-1.82; case-control studies OR 0.85; 95% CI, 0.65-1.12). In the subgroup analysis of patients with a shockable rhythm as an initial rhythm, survival to hospital discharge was significantly improved in the CCR group (cohort studies OR, 2.03; 95% CI, 1.44-2.86). However, when only noncardiac origin cardiac arrest was taken into consideration, survival rate was better in the CPR group (cohort studies OR, 0.87; 95% CI, 0.77-0.98). CONCLUSION: Cardiocerebral resuscitation might be equivalent or superior to CPR in patients with OHCA in both survival rate and neurologic benefits. Further work is needed to assess the efficacy of CCR for victims who had OHCA of noncardiac causes.
OBJECTIVE: The objective of this study is to evaluate the efficacy of cardiocerebral resuscitation (CCR) vs cardiopulmonary resuscitation (CPR) for patients with out-of-hospital cardiac arrest (OHCA). METHODS: We conducted a systematic review of controlled trials and observational studies. We searched Cochrane Central Register of Controlled Trials; MEDLINE; Embase; and Chinese databases such as VIP, CNKI, WANFANG, and CBM from their inception to September 2010. Data from original studies were extracted and assessed with predefined criteria. RESULTS: Thirteen studies comprising 3 randomized controlled trials and 10 observational studies were included. Pooled analysis of 4 observational studies suggested that neurologically intact survival of patients with OHCA was improved in CCR group (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.07-1.97). Survival to hospital discharge in the CCR group was superior or at least equal to that in CPR group (randomized controlled trial OR, 1.25; 95% CI, 1.01-1.55; cohort studies OR, 1.15; 95% CI, 0.72-1.82; case-control studies OR 0.85; 95% CI, 0.65-1.12). In the subgroup analysis of patients with a shockable rhythm as an initial rhythm, survival to hospital discharge was significantly improved in the CCR group (cohort studies OR, 2.03; 95% CI, 1.44-2.86). However, when only noncardiac origin cardiac arrest was taken into consideration, survival rate was better in the CPR group (cohort studies OR, 0.87; 95% CI, 0.77-0.98). CONCLUSION: Cardiocerebral resuscitation might be equivalent or superior to CPR in patients with OHCA in both survival rate and neurologic benefits. Further work is needed to assess the efficacy of CCR for victims who had OHCA of noncardiac causes.