Mechanical chest compression devices have been developed to improve the effectiveness of cardiopulmonary resuscitation (CPR). But the neurological benefit of mechanical chest compression is uncertain.
To assess the effectiveness of mechanical chest compression versus manual chest compression on the neurological outcomes in patients who suffered cardiac arrest using a meta-analysis.
By searching the Cochrane library, Pubmed, Embase and Web of Science datebase, 10 clinical controlled trials from 1990 to July 2018 were included our study, and 6 trials among them were to compare the neurological outcomes of mechanical chest compression and manual chest compression. We used the Cochrane Collaboration Network Risk Assessment Tool and the Newcastle-Orrawa Scale (NOS) for quality assessment and RevMan 5.3 for data analysis. Use relative risk (RR) and 95% confidence interval (CI) to pool the effect.
Compared with manual chest compression, mechanical chest compression did not significantly improve survival with good neurological outcome to hospital discharge (RR 0.78, 95% CI 0.60–1.00, P = 0.05), ROSC (RR = 0.97,95% CI 0.92–1.02, p = 0.20, I2 = 38%) and short-term (survival to hospital admission or survival to 4 hours) survival (RR = 1.00,95% CI 0.92–1.09, p = 0.97, I2 = 0%;). In addition, compared with manual chest compression, mechanical chest compression were associated with higher survival to hospital discharge (RR = 0.86,95% CI 0.76–0.97, p = 0.01,I2 = 36%).
Mechanical chest compression devices should not be recommended to be used conventionally during CPR in adult patients with cardiac arrest.