scholarly journals Standard cardiopulmonary resuscitation versus chest compressions only after out-of-hospital cardiac arrest: a protocol for systematic review and meta-analysis

2021 ◽  
Author(s):  
Qin Qin
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Meta Analysis ◽  
Chest Compressions ◽  
Hospital Cardiac Arrest

scholarly journals Survival of pediatric patients after cardiopulmonary resuscitation for in-hospital cardiac arrest: a systematic review and meta-analysis

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Melaku Bimerew ◽  
Adam Wondmieneh ◽  
Getnet Gedefaw ◽  
Teshome Gebremeskel ◽  
Asmamaw Demis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Hospital Discharge ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Probability Of Survival ◽  
Pooled Prevalence ◽  
Hospital Cardiac Arrest

Abstract Background In-hospital cardiac arrest is a major public health issue. It is a serious condition; most probably end up with death within a few minutes even with corrective measures. However, cardiopulmonary resuscitation is expected to increase the probability of survival and prevent neurological disabilities in patients with cardiac arrest. Having a pooled prevalence of survival to hospital discharge after cardiopulmonary resuscitation is vital to develop strategies targeted to increase probability of survival among patients with cardiac arrest. Therefore, this systematic review and meta-analysis was aimed to assess the pooled prevalence of survival to hospital discharge among pediatric patients who underwent cardiopulmonary resuscitation for in-hospital cardiac arrest. Methods PubMed, Google Scholar, and Cochrane review databases were searched. To have current (five-year) evidence, only studies published in 2016 to 2020 were included. The weighted inverse variance random-effects model at 95%CI was used to estimate the pooled prevalence of survival. Heterogeneity assessment, test of publication bias, and subgroup analyses were also employed accordingly. Results Twenty-five articles with a total sample size of 28,479 children were included in the final analysis. The pooled prevalence of survival to hospital discharge was found to be 46% (95% CI = 43.0–50.0%; I2 = 96.7%; p < 0.001). Based on subgroup analysis by “continent” and “income level”, lowest prevalence of pooled survival was observed in Asia (six studies; pooled survival =36.0% with 95% CI = 19.01–52.15%; I2 = 97.4%; p < 0.001) and in low and middle income countries (six studies, pooled survival = 34.0% with 95% CI = 17.0–51.0%, I2 = 97.67%, p < 0.001) respectively. Conclusion Although there was an extremely high heterogeneity among reported results (I2 = 96.7%), in this meta-analysis more than half of pediatric patients (54%) who underwent cardiopulmonary resuscitation for in-hospital cardiac arrest did not survived to hospital discharge. Therefore, developing further strategies and encouraging researches might be crucial.

scholarly journals Neurological outcome after extracorporeal cardiopulmonary resuscitation for in-hospital cardiac arrest: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Benjamin Gravesteijn ◽  
Marc Schluep ◽  
Maksud Disli ◽  
Prakriti Garkhail ◽  
Dinis Dos Reis Miranda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Favourable Outcome ◽  
Secondary Outcome ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest

Abstract BackgroundIn hospital cardiac arrest (IHCA) is a major adverse event with a high mortality rate if not treated appropriately. Extracorporeal cardiopulmonary resuscitation (ECPR), as adjunct to conventional cardiopulmonary resuscitation (CCPR) is a promising technique for IHCA treatment. Evidence pertaining to neurological outcomes after ECPR is still scarce. MethodsWe performed a comprehensive systematic search of all studies up to December 20th 2019. Our primary outcome was neurological outcome after ECPR at any moment after hospital discharge, defined by the Cerebral Performance Category (CPC) score. A score of 1 or 2 was defined as favourable outcome. Our secondary outcome was post-discharge mortality. A fixed-effects meta-analysis was performed. ResultsOur search yielded 1215 results, of which 19 studies were included in this systematic review. The average survival rate was 31% (95% CI: 28-33%, I2=0%, p=0.26). In the surviving patients, the pooled percentage of favourable neurological outcome was 83% (95% CI: 79-87%, I2=24%, p=0.75). ConclusionECPR as treatment for in-hospital cardiac arrest is associated with a large proportion of patients with good neurological outcome. The large proportion of favourable outcome could potentially be explained by the selection of patients for treatment using ECPR. Moreover, survival is higher than described in the conventional CPR literature. As indications for ECPR might extend to older or more fragile patient populations in the future, research should focus on increasing survival, while maintaining optimal neurological outcome.

scholarly journals Neurological outcome after extracorporeal cardiopulmonary resuscitation for in-hospital cardiac arrest: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Benjamin Gravesteijn ◽  
Marc Schluep ◽  
Maksud Disli ◽  
Prakriti Garkhail ◽  
Dinis Dos Reis Miranda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Favourable Outcome ◽  
Secondary Outcome ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest

Abstract Background: In hospital cardiac arrest (IHCA) is a major adverse event with a high mortality rate if not treated appropriately. Extracorporeal cardiopulmonary resuscitation (ECPR), as adjunct to conventional cardiopulmonary resuscitation (CCPR) is a promising technique for IHCA treatment. Evidence pertaining to neurological outcomes after ECPR is still scarce. Methods: We performed a comprehensive systematic search of all studies up to December 20th 2019. Our primary outcome was neurological outcome after ECPR at any moment after hospital discharge, defined by the Cerebral Performance Category (CPC) score. A score of 1 or 2 was defined as favourable outcome. Our secondary outcome was post-discharge mortality. A fixed-effects meta-analysis was performed. Results: Our search yielded 1215 results, of which 19 studies were included in this systematic review. The average survival rate was 30% (95% CI: 28-33%, I2=0%, p=0.24). In the surviving patients, the pooled percentage of favourable neurological outcome was 84% (95% CI: 80-88%, I2=24%, p=0.90). Conclusion: CPR as treatment for in-hospital cardiac arrest is associated with a large proportion of patients with good neurological outcome. The large proportion of favourable outcome could potentially be explained by the selection of patients for treatment using ECPR. Moreover, survival is higher than described in the conventional CPR literature. As indications for ECPR might extend to older or more fragile patient populations in the future, research should focus on increasing survival, while maintaining optimal neurological outcome.

scholarly journals Automated mechanical cardiopulmonary resuscitation devices versus manual chest compressions in the treatment of cardiac arrest: protocol of a systematic review and meta-analysis comparing machine to human

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042062
Author(s):  
Manuel Obermaier ◽  
Johannes B Zimmermann ◽  
Erik Popp ◽  
Markus A Weigand ◽  
Sebastian Weiterer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Chest Compressions ◽  
Term Survival ◽  
Statistical Heterogeneity ◽  
Mechanical Cpr

IntroductionCardiac arrest is a leading cause of death in industrialised countries. Cardiopulmonary resuscitation (CPR) guidelines follow the principles of closed chest compression as described for the first time in 1960. Mechanical CPR devices are designed to improve chest compression quality, thus considering the improvement of resuscitation outcomes. This protocol outlines a systematic review and meta-analysis methodology to assess trials investigating the therapeutic effect of automated mechanical CPR devices at the rate of return of spontaneous circulation, neurological state and secondary endpoints (including short-term and long-term survival, injuries and surrogate parameters for CPR quality) in comparison with manual chest compressions in adults with cardiac arrest.Methods and analysisA sensitive search strategy will be employed in established bibliographic databases from inception until the date of search, followed by forward and backward reference searching. We will include randomised and quasi-randomised trials in qualitative analysis thus comparing mechanical to manual CPR. Studies reporting survival outcomes will be included in quantitative analysis. Two reviewers will assess independently publications using a predefined data collection form. Standardised tools will be used for data extraction, risks of bias and quality of evidence. If enough studies are identified for meta-analysis, the measures of association will be calculated by dint of bivariate random-effects models. Statistical heterogeneity will be evaluated by I2-statistics and explored through sensitivity analysis. By comprehensive subgroup analysis we intend to identify subpopulations who may benefit from mechanical or manual CPR techniques. The reporting follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Ethics and disseminationNo ethical approval will be needed because data from previous studies will be retrieved and analysed. Most resuscitation studies are conducted under an emergency exception for informed consent. This publication contains data deriving from a dissertation project. We will disseminate the results through publication in a peer-reviewed journal and at scientific conferences.PROSPERO registration numberCRD42017051633.

scholarly journals Neurological outcome after extracorporeal cardiopulmonary resuscitation for in-hospital cardiac arrest: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Benjamin Gravesteijn ◽  
Marc Schluep ◽  
Maksud Disli ◽  
Prakriti Garkhail ◽  
Dinis Dos Reis Miranda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Favourable Outcome ◽  
Secondary Outcome ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest

Abstract Background In hospital cardiac arrest (IHCA) is a major adverse event with a high mortality rate if not treated appropriately. Extracorporeal cardiopulmonary resuscitation (ECPR), as adjunct to conventional cardiopulmonary resuscitation (CCPR) is a promising technique for IHCA treatment. Evidence pertaining to neurological outcomes after ECPR is still scarce. Methods We performed a comprehensive systematic search of all studies up to December 20 th 2019. Our primary outcome was neurological outcome after ECPR at any moment after hospital discharge, defined by the Cerebral Performance Category (CPC) score. A score of 1 or 2 was defined as favourable outcome. Our secondary outcome was post-discharge mortality. A fixed-effects meta-analysis was performed. Results Our search yielded 1215 results, of which 19 studies were included in this systematic review. The average survival rate was 32% (95% CI: 29-34%, I2=0%, p=0.16). In the surviving patients, the pooled percentage of favourable neurological outcome was 82% (95% CI: 77- 85%, I2=60%, p=0.12). Conclusion ECPR as treatment for in-hospital cardiac arrest is associated with a large proportion of patients with good neurological outcome. The large proportion of favourable outcome could potentially be explained by the selection of patients for treatment using ECPR. Moreover, survival is higher than described in the conventional CPR literature. As indications for ECPR might extend to older or more fragile patient populations in the future, research should focus on increasing survival, while maintaining optimal neurological outcome.

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