Couper, Keith, Yeung, Joyce, Nicholson, Thomas, Quinn, Tom, 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. doi:10.1016/j.resuscitation.2016.03.004 ISSN 0300-9572.

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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 2.36, 95% CI 1.44–3.89) 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:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Cardiac resuscitation
Journal or Publication Title:	Resuscitation
Publisher:	Elsevier Ireland Ltd
ISSN:	0300-9572
Official Date:	June 2016
Dates:	Date Event June 2016 Published 11 March 2016 Available 7 March 2016 Accepted 26 January 2016 Submitted
Volume:	103
Page Range:	pp. 24-31
DOI:	10.1016/j.resuscitation.2016.03.004
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	24 March 2016
Date of first compliant Open Access:	11 March 2017
Funder:	National Institute for Health Research (Great Britain) (NIHR)

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