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Events

02 Oct 2018 - 03 Oct 2018
05 Oct 2018 - 06 Oct 2018

Mechanical CPR Devices Less Effective Than Standard Approach

By HospiMedica International staff writers
Posted on 04 Sep 2018
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Image: The Easy Pulse CPR compression device (Photo courtesy of Schiller).
Image: The Easy Pulse CPR compression device (Photo courtesy of Schiller).
A new study concludes that mechanical cardiopulmonary resuscitation (CPR) is associated with decreased return of spontaneous circulation (ROSC) and survival.

Researchers at the University of Texas (Austin, TX, USA), Austin-Travis County Emergency Medical Services System (Austin, TX, USA), and other institutions conducted a study of out-of-hospital cardiac arrest (OHCA) outcomes, comparing patients managed with mandatory mechanical CPR performed by emergency medical services (EMS) to patients managed via a consistent team approach to manual CPR resuscitation, and a scripted sequence for initiation of mechanical CPR. The protocol was standardized during a quality improvement program launched in 2015.

The researchers then analyzed outcomes of 444 adult, non-traumatic OHCA attended in the following year, using matched analysis to compare ROSC, survival to discharge, and neurologic status among 217 patients managed with manual CPR, versus 227 who received mechanical CPR. The results revealed that both ROSC and survival to discharge were higher with the “pit crew” approach. In propensity-matched analysis, both ROSC (38.6%) and survival to discharge (13.6%) were higher for manual CPR than for mechanical CPR (28.4% and 6.8%), respectively. The study was published on August 11, 2018, in the American Journal of Emergency Medicine.

“Through a year-long quality improvement effort, we standardized the initial resuscitative efforts for OHCA, prioritizing a ‘pit crew’ approach to high quality manual CPR, early defibrillation, and basic airway management ahead of a scripted sequence for initiating mechanical CPR,” concluded lead author Louis Gonzales, MPH, of the Austin-Travis County EMS System, and colleagues. “We found mechanical CPR was associated with decreased return of spontaneous circulation and decreased survival to discharge.”

Mechanical CPR systems are devices designed to improve blood flow to a patient’s heart and brain during sudden cardiac arrest by providing uninterrupted CPR chest compressions, which help maintain myocardial and cerebral perfusion. Examples include the ZOLL AutoPulse, a load-distributing band that delivers circumferential compressions by squeezing the entire chest, and the Schiller Easy Pulse, an electrical mechanical chest compression device that delivers multidirectional chest compressions at a consistent rate and depth.

Related Links:
University of Texas
Austin-Travis County Emergency Medical Services System


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