The Effect Of Cardiopulmonary Resuscitator On Cardiac Arrest:a Systematic Review

Objective Since 2000,the first mechanical chest compression device had beendeveloped to facilitate continuous delivery of high quality of cardiopulmonary resuscitation(CPR).Despite positive hemodynamic effect,evidence on survival rates remains uncertain.In the latest 5 years,3 randomized controlled trials have been performed with high quality.we now need to implement a meta-analysis on the effect of mechanical versus manual CPR on survival rates after out-of-hospital cardiac arrest.Methods Through a systematic search on PubMed,Web of Science,EMBASE,the Cochrane Libraries,WanFang Data and CNKI,all eligible studies including both randomized controlled trials and nonrandomized studies that compared a mechanical CPR with manual CPR only.Outcome variables were survival to hospital admission,survival to discharge,and favorable neurologic outcome.Results.Twenty-six studies(n=22237)were included: 5 randomized controlled trials and 21 nonrandomized studies,analysed separately.As for survival to admission,no difference was found between mechanical and manual group in the randomized controlled trials(odds ratio 0.94,95% confidence interval 0.84 to 1.05,P=0.24).In comparison,meta-analysis of nonrandomized studies suggested a benefit in favor of mechanical CPR(odds ratio 1.49,95% confidence interval 1.25 to 1.78,P<0.001).No interaction was detected between the CPR guidelines(2000 versus 2005)and the CPR methods(P=0.27).Survival to discharge and neurologic outcome did not differ between mechanical and manual group.Conclusions Although there are lower-quality,observational data that suggest that mechanical CPR may improve survival to hospital admission,the cumulative high-quality randomized trials do not support a routine application of mechanical CPR to improve survival rate or favorable neurologic outcome.