Effectiveness of mechanical chest compression for out-of-hospital cardiac arrest patients in an emergency department

This study was to identify the effect of epinephrine on the survival of out-of-hospital cardiac arrest (OHCA) patients and changes in prehospital emergency medical services (EMSs) after the introduction of prehospital epinephrine use by EMS providers. This was a retrospective observational study comparing two groups (epinephrine group and norepinephrine group). We used propensity score matching of the two groups and identified the association between outcome variables regarding survival and epinephrine use, controlling for confounding factors. The epinephrine group was 339 patients of a total 1943 study population. The survival-to-discharge rate and OR (95% CI) of the epinephrine group were 5.0% (p = 0.215) and 0.72 (0.43–1.21) in the total patient population and 4.7% (p = 0.699) and 1.15 (0.55–2.43) in the 1:1 propensity-matched population. The epinephrine group received more mechanical chest compression and had longer EMS response times and scene times than the norepinephrine group. Mechanical chest compression was a negative prognostic factor for survival to discharge and favorable neurological outcomes in the epinephrine group. The introduction of prehospital epinephrine use in OHCA patients yielded no evidence of improvement in survival to discharge and favorable neurological outcomes and adversely affected the practice of EMS providers, exacerbating the factors negatively associated with survival from OHCA.

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Mechanical Versus Manual Chest Compression: A Retrospective-Cohort in Out-of-Hospital Cardiac Arrest

Acta Medica ◽

10.32552/2021.actamedica.657 ◽

2021 ◽

pp. 1-7

Author(s):

Alp Şener ◽

Gül Pamukçu Günaydın ◽

Fatih Tanrıverdi

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Chest Compression ◽

Survival Rates ◽

Spontaneous Circulation ◽

Retrospective Case ◽

Return Of Spontaneous Circulation ◽

Mechanical Chest Compression ◽

Manual Chest Compression ◽

Hospital Cardiac Arrest

Objective: In cardiac arrest cases, high quality cardiopulmonary resuscitation and effective chest compression are vital issues in improving survival with good neurological outcomes. In this study, we investigated the effect of mechanical chest compression devices on 30- day survival in out-of-hospital cardiac arrest. Materials and Methods: This retrospective case-control study was performed on patients who were over 18 years of age and admitted to the emergency department for cardiac arrest between January 1, 2016 and January 15, 2018. Manual chest compression was performed to the patients before January 15, 2017, and mechanical chest compression was performed after this date. Return of spontaneous circulation, hospital discharge, and 30-day survival rates were compared between the groups of patients in terms of chest compression type. In this study, the LUCAS-2 model piston-based mechanical chest compression device was used for mechanical chest compressions. Results: The rate of return of spontaneous circulation was significantly lower in the mechanical chest compression group (11.1% vs 33.1%; p < 0.001). The 30-day survival rate was higher in the manual chest compression group (6.8% vs 3.7%); however, this difference was not statistically significant (p = 0.542). Furthermore, 30-day survival was 0% in the trauma group and 0.6% in the patient group who underwent cardiopulmonary resuscitation for over 20 minutes. Conclusion: It can be seen that the effect of mechanical chest compression on survival is controversial; studies on this issue should continue and, furthermore, studies on the contribution of mechanical chest compression on labor loss should be conducted.

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Quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest before and after introduction of a mechanical chest compression device, LUCAS-2; a prospective, observational study

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-015-0114-2 ◽

2015 ◽

Vol 23 (1) ◽

Cited By ~ 22

Author(s):

Tinne Tranberg ◽

Jens F Lassen ◽

Anne K Kaltoft ◽

Troels M Hansen ◽

Carsten Stengaard ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Observational Study ◽

Chest Compression ◽

Prospective Observational Study ◽

Compression Device ◽

Mechanical Chest Compression ◽

Before And After ◽

Hospital Cardiac Arrest

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Mechanical chest compressions and survival in the emergency setting

Journal of Paramedic Practice ◽

10.12968/jpar.2021.13.2.62 ◽

2021 ◽

Vol 13 (2) ◽

pp. 62-68

Author(s):

Paul Williams ◽

Rob Goring ◽

John Franklin

Keyword(s):

Systematic Review ◽

Cardiac Arrest ◽

Chest Compression ◽

Survival Rates ◽

Emergency Setting ◽

Mechanical Device ◽

Training Environment ◽

Training Time ◽

Mechanical Chest Compression ◽

Hospital Cardiac Arrest

Advances in cardiac arrest management have led to the use of a mechanical chest compression device in an attempt to improve outcomes in cardiopulmonary resuscitation (CPR). This systematic review set out to identify whether the inclusion of the mechanical device improves survival rates in the cardiac arrest patient within the emergency setting, and explored the themes: training, environment and time of device deployment. The systematic review measured the value of mechanical chest compression devices versus standard manual compressions in respect to resuscitation outcomes (return of spontaneous circulation). Ten studies with data from 12 894 adult patients, who presented with out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA), were included. Results demonstrated an equality between manual and mechanical CPR with a statistical increase in survival when the mechanical device is used. Training, time of deployment, guideline adherence and timing of rhythm check/defibrillation presented challenges in the analysis of the data.

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