- Patients experiencing out-of-hospital cardiac arrest (OHCA) are more likely to survive if rescuers used manual rather than mechanical chest compressions during highly choreographed resuscitations.
- Authors: “Our system now uses mechanical CPR only for moving patients, managing rescuer fatigue in prolonged resuscitations, and/or for ongoing resuscitations during transport to hospital.”
Why this matters
- Use of mechanical CPR devices is growing.
- In 2013, Austin-Travis County (Texas) emergency medical service (EMS) linked interruptions in chest compressions from mechanical CPR devices to flattened OHCA survival.
- Manual vs mechanical CPR (unadjusted):
- Survival: OR, 2.6 (95% CI, 1.3-5.3);
- Return of spontaneous circulation (ROSC): OR, 1.6 (95% CI, 1.1-2.3).
- Manual vs mechanical CPR (propensity-matched):
- Survival: 13.6% (n=24) vs 6.8% (n=12) (difference, 6.8%; 95% CI, 0.5%-13.3%);
- ROSC: 38.6% (n=68) vs 28.4% (n=50) (difference, 10.2%; 95% CI, 0.4%-20.0%).
- Retrospective, observational cohort study of 444 adult, nontraumatic OHCAs attended by Austin-Travis County EMS in 2016.
- Researchers developed, trained crews in choreographed "pit crew" resuscitations incorporating mechanical CPR.
- Not all responders had mechanical unit available.
- Using propensity-score matching, researchers evaluated mechanical vs manual chest compressions in patients who did not respond to early resuscitation.
- Outcome was survival to hospital discharge.
- Funding: None.
- Single-system, nonrandomized study.