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Mechanical chest compression devices at in-hospital cardiac arrest: A systematic review and meta-analysis.

Couper, Keith and Yeung, Joyce and Nicholson, Thomas and Quinn, Tom and Lall, Ranjit and Perkins, Gavin D (2016) Mechanical chest compression devices at in-hospital cardiac arrest: A systematic review and meta-analysis. Resuscitation, 103. pp. 24-31. ISSN 1873-1570.

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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.

Item Type: Article
Subjects: WG Cardiovascular system. Cardiology
Divisions: Emergency Services > Cardiology
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 06 Apr 2016 09:32
Last Modified: 06 Apr 2016 09:32
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1069

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