Mechanical chest compression for out of hospital cardiac arrest: Systematic review and meta-analysis

Abstract Aim To summarise the evidence from randomised controlled trials of mechanical chest compression devices used during resuscitation after out of hospital cardiac arrest. Methods Systematic review of studies evaluating the effectiveness of mechanical chest compression. We included randomised controlled trials or cluster randomised trials that compared mechanical chest compression (using any device) with manual chest compression for adult patients following out-of-hospital cardiac arrest. Outcome measures were return of spontaneous circulation, survival of event, overall survival, survival with good neurological outcome. Results were combined using random-effects meta-analysis. Data sources Studies were identified by searches of electronic databases, reference lists of other studies and review articles. Results Five trials were included, of which three evaluated the LUCAS or LUCAS-2 device and two evaluated the AutoPulse device. The results did not show an advantage to the use of mechanical chest compression devices for survival to discharge/30 days (average OR 0.89, 95% CI 0.77, 1.02) and survival with good neurological outcome (average OR 0.76, 95% CI 0.53, 1.11). Conclusions Existing studies do not suggest that mechanical chest compression devices are superior to manual chest compression, when used during resuscitation after out of hospital cardiac arrest.