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Metrics of mechanical chest compression device use in out‐of‐hospital cardiac arrest

Levy, Michael ; Kerin, Karl B ; Yost, Dana ; Chapman, Fred and Madsen Härdig, Bjarne LU (2020) In Journal of the American college of emergency physicians open 1(6). p.1214-1221
Abstract
Objective
The quality of cardiopulmonary resuscitation (CPR) affects outcomes from cardiac arrest, yet manual CPR is difficult to administer. Although mechanical CPR (mCPR) devices offer high quality CPR, only limited data describe their deployment, their interaction with standard manual CPR (sCPR), and the consequent effects on chest compression continuity and patient outcomes. We sought to describe the interaction between sCPR and mCPR and the impact of the sCPR‐mCPR transition upon outcomes in adult out‐of‐hospital cardiac arrest (OHCA).
Methods
We analyzed all adult ventricular fibrillation OHCA treated by the Anchorage Fire Department (AFD) during calendar year 2016. AFD protocols include the immediate initiation of sCPR... (More)
Objective
The quality of cardiopulmonary resuscitation (CPR) affects outcomes from cardiac arrest, yet manual CPR is difficult to administer. Although mechanical CPR (mCPR) devices offer high quality CPR, only limited data describe their deployment, their interaction with standard manual CPR (sCPR), and the consequent effects on chest compression continuity and patient outcomes. We sought to describe the interaction between sCPR and mCPR and the impact of the sCPR‐mCPR transition upon outcomes in adult out‐of‐hospital cardiac arrest (OHCA).
Methods
We analyzed all adult ventricular fibrillation OHCA treated by the Anchorage Fire Department (AFD) during calendar year 2016. AFD protocols include the immediate initiation of sCPR upon rescuer arrival and transition to mCPR, guided by patient status. We compared CPR timing, performance, and outcomes between those receiving sCPR only and those receiving sCPR transitioning to mCPR (sCPR + mCPR).
Results
All 19 sCPR‐only patients achieved return of spontaneous circulation (ROSC) after a median of 3.3 (interquartile range 2.2–5.1) minutes. Among 30 patients remaining pulseless after sCPR (median 6.9 [5.3–11.0] minutes), transition to mCPR occurred with a median chest compression interruption of 7 (5–13) seconds. Twenty‐one of 30 sCPR + mCPR patients achieved ROSC after a median of 11.2 (5.7–23.8) additional minutes of mCPR. Survival differed between groups: sCPR only 14/19 (74%) versus sCPR + mCPR 13/30 (43%), P = 0.045.
Conclusion
In this series, transition to mCPR occurred in patients unresponsive to initial sCPR with only brief interruptions in chest compressions. Assessment of mCPR must consider the interactions with sCPR. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of the American college of emergency physicians open
volume
1
issue
6
pages
1214 - 1221
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:33392525
  • scopus:85131018929
ISSN
2688-1152
DOI
10.1002/emp2.12184
project
Helsingborg Resuscitation and Cardiovascular Research Group
language
English
LU publication?
yes
id
b79c75ea-9ea4-4029-9523-5e3714ba6efb
date added to LUP
2020-07-06 11:18:39
date last changed
2023-05-24 04:08:05
@article{b79c75ea-9ea4-4029-9523-5e3714ba6efb,
  abstract     = {{Objective<br/>The quality of cardiopulmonary resuscitation (CPR) affects outcomes from cardiac arrest, yet manual CPR is difficult to administer. Although mechanical CPR (mCPR) devices offer high quality CPR, only limited data describe their deployment, their interaction with standard manual CPR (sCPR), and the consequent effects on chest compression continuity and patient outcomes. We sought to describe the interaction between sCPR and mCPR and the impact of the sCPR‐mCPR transition upon outcomes in adult out‐of‐hospital cardiac arrest (OHCA).<br/>Methods<br/>We analyzed all adult ventricular fibrillation OHCA treated by the Anchorage Fire Department (AFD) during calendar year 2016. AFD protocols include the immediate initiation of sCPR upon rescuer arrival and transition to mCPR, guided by patient status. We compared CPR timing, performance, and outcomes between those receiving sCPR only and those receiving sCPR transitioning to mCPR (sCPR + mCPR).<br/>Results<br/>All 19 sCPR‐only patients achieved return of spontaneous circulation (ROSC) after a median of 3.3 (interquartile range 2.2–5.1) minutes. Among 30 patients remaining pulseless after sCPR (median 6.9 [5.3–11.0] minutes), transition to mCPR occurred with a median chest compression interruption of 7 (5–13) seconds. Twenty‐one of 30 sCPR + mCPR patients achieved ROSC after a median of 11.2 (5.7–23.8) additional minutes of mCPR. Survival differed between groups: sCPR only 14/19 (74%) versus sCPR + mCPR 13/30 (43%), P = 0.045. <br/>Conclusion<br/>In this series, transition to mCPR occurred in patients unresponsive to initial sCPR with only brief interruptions in chest compressions. Assessment of mCPR must consider the interactions with sCPR.}},
  author       = {{Levy, Michael and Kerin, Karl B and Yost, Dana and Chapman, Fred and Madsen Härdig, Bjarne}},
  issn         = {{2688-1152}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{6}},
  pages        = {{1214--1221}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Journal of the American college of emergency physicians open}},
  title        = {{Metrics of mechanical chest compression device use in out‐of‐hospital cardiac arrest}},
  url          = {{http://dx.doi.org/10.1002/emp2.12184}},
  doi          = {{10.1002/emp2.12184}},
  volume       = {{1}},
  year         = {{2020}},
}