Mechanical versus manual chest compression CPR under ground ambulance transport conditions

[Background] Recently, the patients with out-of-hospital cardiac arrest are increasing. It is very important to do chest compression continuously for the return of spontaneous circulation (ROSC). But we can not but stop chest compression during checking pulse every few minutes. We reported that Regional cerebral Oxygen Saturation (rSO2) value was not elevated by manual chest compression and mechanical chest compression increased a little rSO2 value on CPR without ROSC and rSO2 value became a good parameter of ROSC in single center study. [Purpose] The purpose of this study is to evaluate clinical utility of rSO2 value during CPR in multicenter study. [Method] Retrospectively, we considered the rSO2 value of the out-of -hospital cardiac arrest patients from December 2012 to December 2014 in multicenter. During CPR, rSO2 were recorded continuously from the forehead of the patients by TOS-OR (Japan). CPR for patients with OHCA was performed according to the JRC-guidelines 2010. [Result] 252 patients with OHCA were included in this study. The rSO2 value on arrival, during CPR and ROSC were 44.4±8.9%, 45.4±9.7%, 58.6±9.2%. In ROSC, with rSO2 cutoff value of 52.7%, the specificity and sensitivity were 80% and 79%, respectively. The negative predict value was 99.2%, respectively. It means little possible to ROSC, if the rSO2 value is less than 52.7%. So, it may be possible to reduce the frequency of checking pulse during CPR. [Conclusion] The monitoring of rSO2 value could reduce the frequency of checking pulse during CPR and do chest compression continuously.

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Defibrillation delivered during the upstroke phase of manual chest compression improves shock success*

Critical Care Medicine ◽

10.1097/ccm.0b013e3181cc4944 ◽

2010 ◽

Vol 38 (3) ◽

pp. 910-915 ◽

Cited By ~ 12

Author(s):

Yongqin Li ◽

Hao Wang ◽

Jun Hwi Cho ◽

Weilun Quan ◽

Gary Freeman ◽

...

Keyword(s):

Chest Compression ◽

Manual Chest Compression

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Leg-heel chest compression as an alternative for medical professionals in times of COVID-19

10.1101/2021.03.09.21253220 ◽

2021 ◽

Author(s):

Matthias Ott ◽

Alexander Krohn ◽

Laurence H. Bilfield ◽

F. Dengler ◽

C. Jaki ◽

...

Keyword(s):

Chest Compression ◽

Effective Alternative ◽

Medical Professionals ◽

Compression Rate ◽

Compression Depth ◽

Significant Difference ◽

Manual Chest Compression ◽

Special Circumstances ◽

Previous Training

AbstractObjectiveTo evaluate leg-heel chest compression without previous training as an alternative for medical professionals and its effects on distance to potential aerosol spread during chest compression.Methods20 medical professionals performed standard manual chest compression followed by leg-heel chest compression after a brief instruction on a manikin. We compared percentage of correct chest compression position, percentage of full chest recoil, percentage of correct compression depth, average compression depth, percentage of correct compression rate and average compression rate between both methods. In a second approach, potential aerosol spread during chest compression was visualized.ResultsThere was no significant difference between manual and leg-heel compression. The distance to potential aerosol spread could have been increased by leg-heel method.ConclusionUnder special circumstances like COVID-19-pandemic, leg-heel chest compression may be an effective alternative without previous training compared to manual chest compression while markedly increasing the distance to the patient.

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Iatrogenic Injuries in Manual and Mechanical Cardiopulmonary Resuscitation

The American Surgeon ◽

10.1177/00031348211047507 ◽

2021 ◽

pp. 000313482110475

Author(s):

Magnus J. Chun ◽

Yichi Zhang ◽

Eman A. Toraih ◽

Patrick R. McGrew

Keyword(s):

Systematic Review ◽

Chest Compression ◽

Meta Analysis ◽

Sternal Fracture ◽

Iatrogenic Injuries ◽

Mechanical Chest Compression ◽

Manual Chest Compression ◽

Significant Life ◽

Life Threatening ◽

Meta Analyses

Purpose Mechanical chest compression has been shown to be equivalent to manual chest compression in providing survival benefits to patients experiencing cardiac arrest. There has been a growing need for a contemporary review of iatrogenic injuries caused by mechanical in comparison with manual chest compression. Our study aims to analyze the studies that document significant life-threatening iatrogenic injuries caused by mechanical and manual chest compression. Methods A systematic review of PubMed and Embase was performed according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. All studies published after January 1st, 2000 were reviewed using inclusion/exclusion criteria and completed by May 2020. A total of 7202 patients enrolled in 15 studies were included in our meta-analysis. Results Significant life-threatening iatrogenic injuries had higher odds of occurring when mechanical chest compression was used compared to manual chest compression, especially for hemothorax and liver lacerations. Mechanical chest compression involves consistently deeper compression depths compared to manual chest compression, potentially resulting in more injuries. In the mechanical chest compression cohort, chest wall fractures had the highest incidence rate (55.7%), followed by sternal fracture (28.3%), lung injuries (3.7%), liver (1.0%), and diaphragm (.2%) lacerations. Conclusions Mechanical chest compression was associated with more iatrogenic injuries as compared to manual chest compression. Further research is needed to define the appropriate application of mechanical in comparison with manual chest compression in different scenarios. Levels of provider training, different mechanical chest compression device types, patient demographics, and compression duration/depth may all play roles in influencing outcomes.

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