A mechanical device that
delivers chest compressions during CPR does not improve short-term survival of
cardiac arrest patients, compared to traditional hand compressions, a new study
"Many factors affect
the chances of survival after cardiac arrest, including early recognition of
arrest, effective CPR and defibrillation, and post-resuscitation care. One
important link is the delivery of high-quality chest compressions to achieve
restoration of spontaneous circulation," wrote authors of the study
published in the Journal of the American Medical Association.
"The effectiveness of
manual chest compressions depends on the endurance and skills of rescuers, and
manual compressions provide only approximately 30% of normal cardiac
output," Dr Sten Rubertsson, of Uppsala University in Sweden and
colleagues explained in the study.
Manual CPR involves
prolonged "hands-off" time and its quality drops most when the patient
is being transported, the authors report. To improve CPR, mechanical
chest-compression devices have been developed.
However, the use of such
devices in patients who suffer out-of-hospital cardiac arrests had not been
tested in large clinical trials, the researchers noted.
This study included nearly
2 600 people who suffered out-of-hospital cardiac arrest in Sweden, Britain and
the Netherlands between January 2008 and February 2013. Ambulance crews gave
half of the patients CPR with a mechanical chest compression device and the
other patients received CPR with hand compressions.
The mechanical device used
an integrated suction cup designed to deliver compressions according to CPR
The four-hour survival
rates was 23.6% for patients who received mechanical CPR and 23.7% for those
who received manual CPR. Among patients who were still alive after six months,
99% of those who received mechanical CPR and 94% of those who received manual
CPR had good neurological outcomes, according to a journal new release.
The type of CPR given
didn't appear to make a difference.
"In patients with
out-of-hospital cardiac arrest, mechanical chest compressions in combination
with defibrillation during ongoing compressions provided no improved four-hour
survival vs. manual CPR according to guidelines. There was a good neurological
outcome in the vast majority of survivors in both groups, and neurological
outcomes improved over time," the researchers wrote.
The American Academy of
Family Physicians has more about CPR