- For patients experiencing out-of-hospital cardiac arrest (OHCA), mechanical CPR was associated with higher rates of return of spontaneous circulation (ROSC) than was manual CPR in this registry study.
- Results contradict those of 2 recent publications using hard clinical outcomes, while a recent Cochrane review concluded mechanical and manual CPR delivered similar outcomes.
Why this matters
- Rescuer fatigue can erode manual CPR quality.
- Studies of survival with mechanical CPR have yielded mixed results.
- ROSC ORs on multivariate analysis, mechanical vs manual CPR:
- Adjusting for epidemiologic and EMS treatment factors: 1.27 (95% CI, 1.09-1.48);
- Adjusting for above plus CPR duration: 1.77 (95% CI, 1.48-2.12).
- Observed vs predicted ROSC rates:
- Manual CPR: 41.2% vs 39.2%;
- Mechanical CPR: 51.5% vs 42.5%;
- Mechanical vs manual difference: P<.001.>
- Retrospective analysis of German Resuscitation Registry data, 2007-2014.
- Authors assessed OHCA patients treated with mechanical vs manual CPR (n=912 vs 18,697, respectively).
- Outcome: ROSC (palpable pulse for ≥20 seconds).
- Funding: None.
- Resuscitations of children and trauma victims, those lasting
- Potential residual confounding.
- No hard clinical outcomes.