Keith Couper1, Joyce Yeung2, Thomas Nicholson3, Tom Quinn4, Ranjit Lall5, Gavin D Perkins6. 1. Warwick Medical School, University of Warwick, Coventry, UK; Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK. 2. Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK; School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK. 3. Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK. 4. Faculty of Health, Social Care and Education, Kingston University London and St. George's, University of London, London, UK. 5. Warwick Medical School, University of Warwick, Coventry, UK. 6. Warwick Medical School, University of Warwick, Coventry, UK; Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK. Electronic address: g.d.perkins@warwick.ac.uk.
Abstract
AIM: To summarise the evidence in relation to the routine use of mechanical chest compression devices during resuscitation from in-hospital cardiac arrest. METHODS: We conducted a systematic review of studies which compared the effect of the use of a mechanical chest compression device with manual chest compressions in adults that sustained an in-hospital cardiac arrest. Critical outcomes were survival with good neurological outcome, survival at hospital discharge or 30-days, and short-term survival (ROSC/1-h survival). Important outcomes included physiological outcomes. We synthesised results in a random-effects meta-analysis or narrative synthesis, as appropriate. Evidence quality in relation to each outcome was assessed using the GRADE system. DATA SOURCES: Studies were identified using electronic databases searches (Cochrane Central, MEDLINE, EMBASE, CINAHL), forward and backward citation searching, and review of reference lists of manufacturer documentation. RESULTS: Eight papers, containing nine studies [689 participants], were included. Three studies were randomised controlled trials. Meta-analyses showed an association between use of mechanical chest compression device and improved hospital or 30-day survival (odds ratio 2.34, 95% CI 1.42-3.85) and short-term survival (odds ratio 2.14, 95% CI 1.11-4.13). There was also evidence of improvements in physiological outcomes. Overall evidence quality in relation to all outcomes was very low. CONCLUSIONS: Mechanical chest compression devices may improve patient outcome, when used at in-hospital cardiac arrest. However, the quality of current evidence is very low. There is a need for randomised trials to evaluate the effect of mechanical chest compression devices on survival for in-hospital cardiac arrest.
AIM: To summarise the evidence in relation to the routine use of mechanical chest compression devices during resuscitation from in-hospital cardiac arrest. METHODS: We conducted a systematic review of studies which compared the effect of the use of a mechanical chest compression device with manual chest compressions in adults that sustained an in-hospital cardiac arrest. Critical outcomes were survival with good neurological outcome, survival at hospital discharge or 30-days, and short-term survival (ROSC/1-h survival). Important outcomes included physiological outcomes. We synthesised results in a random-effects meta-analysis or narrative synthesis, as appropriate. Evidence quality in relation to each outcome was assessed using the GRADE system. DATA SOURCES: Studies were identified using electronic databases searches (Cochrane Central, MEDLINE, EMBASE, CINAHL), forward and backward citation searching, and review of reference lists of manufacturer documentation. RESULTS: Eight papers, containing nine studies [689 participants], were included. Three studies were randomised controlled trials. Meta-analyses showed an association between use of mechanical chest compression device and improved hospital or 30-day survival (odds ratio 2.34, 95% CI 1.42-3.85) and short-term survival (odds ratio 2.14, 95% CI 1.11-4.13). There was also evidence of improvements in physiological outcomes. Overall evidence quality in relation to all outcomes was very low. CONCLUSIONS: Mechanical chest compression devices may improve patient outcome, when used at in-hospital cardiac arrest. However, the quality of current evidence is very low. There is a need for randomised trials to evaluate the effect of mechanical chest compression devices on survival for in-hospital cardiac arrest.
Authors: Jerry P Nolan; Robert A Berg; Stephen Bernard; Bentley J Bobrow; Clifton W Callaway; Tobias Cronberg; Rudolph W Koster; Peter J Kudenchuk; Graham Nichol; Gavin D Perkins; Tom D Rea; Claudio Sandroni; Jasmeet Soar; Kjetil Sunde; Alain Cariou Journal: Intensive Care Med Date: 2017-03-11 Impact factor: 17.440
Authors: Manuel Obermaier; Johannes B Zimmermann; Erik Popp; Markus A Weigand; Sebastian Weiterer; Alexander Dinse-Lambracht; Claus-Martin Muth; Benedikt L Nußbaum; Jan-Thorsten Gräsner; Stephan Seewald; Katrin Jensen; Svenja E Seide Journal: BMJ Open Date: 2021-02-15 Impact factor: 2.692
Authors: Jasmeet Soar; Bernd W Böttiger; Pierre Carli; Keith Couper; Charles D Deakin; Therese Djärv; Carsten Lott; Theresa Olasveengen; Peter Paal; Tommaso Pellis; Gavin D Perkins; Claudio Sandroni; Jerry P Nolan Journal: Notf Rett Med Date: 2021-06-08 Impact factor: 0.826
Authors: Jorge López; Sarah N Fernández; Rafael González; María J Solana; Javier Urbano; Blanca Toledo; Jesús López-Herce Journal: PLoS One Date: 2017-11-30 Impact factor: 3.240
Authors: Keith Couper; Rochelle M Velho; Tom Quinn; Anne Devrell; Ranjit Lall; Barry Orriss; Joyce Yeung; Gavin D Perkins Journal: BMJ Open Date: 2018-02-01 Impact factor: 2.692
Authors: Keith Couper; Tom Quinn; Ranjit Lall; Anne Devrell; Barry Orriss; Kate Seers; Joyce Yeung; Gavin D Perkins Journal: Scand J Trauma Resusc Emerg Med Date: 2018-08-30 Impact factor: 2.953