Quantifying the Effect of Cardiopulmonary Resuscitation Quality on Cardiac Arrest Outcome A Systematic Review and Meta-Analysis

被引:90
|
作者
Wallace, Sarah K. [1 ,2 ,3 ]
Abella, Benjamin S. [1 ,2 ]
Becker, Lance B. [1 ,2 ]
机构
[1] Univ Penn, Ctr Resuscitat Sci, Philadelphia, PA 19104 USA
[2] Univ Penn, Dept Emergency Med, Philadelphia, PA 19104 USA
[3] Univ Penn, Doris Duke Clin Res Fellowship Program, Philadelphia, PA 19104 USA
来源
CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES | 2013年 / 6卷 / 02期
关键词
cardiac arrest; cardiopulmonary resuscitation; heart arrest; meta-analysis; resuscitation; CHEST COMPRESSION; SURVIVAL; VENTILATION; RATES; GUIDELINES; CHILDREN; OUTPUT; DEPTH;
D O I
10.1161/CIRCOUTCOMES.111.000041
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Evidence has accrued that cardiopulmonary resuscitation quality affects cardiac arrest outcome. However, the relative contributions of chest compression components (such as rate and depth) to successful resuscitation remain unclear. Methods and Results-We sought to measure the effect of cardiopulmonary resuscitation quality on cardiac arrest outcome through systematic review and meta-analysis. We searched for any clinical study assessing cardiopulmonary resuscitation performance on adult cardiac arrest patients in which survival was a reported outcome, either return of spontaneous circulation or survival to admission or discharge. Of 603 identified abstracts, 10 studies met inclusion criteria. Effect sizes were reported as mean differences. Missing data were resolved by author contact. Estimates were segregated by cardiopulmonary resuscitation metric (chest compression rate, depth, no-flow fraction, and ventilation rate), and a random-effects model was applied to estimate an overall pooled effect. Arrest survivors were significantly more likely to have received deeper chest compressions than nonsurvivors (mean difference, 2.44 mm; 95% confidence interval, 1.19-3.69 [P<0.001]; n=6 studies; I-2=0.0%; P for heterogeneity=0.9). Likewise, survivors were significantly more likely to have received chest compression rates closer to 85 to 100 compressions per minute (cpm) than nonsurvivors (absolute mean difference from 85 cpm, -4.81 cpm; 95% confidence interval, -8.19 to -1.43 [P=0.005]; from 100 cpm, -5.04 cpm; 95% confidence interval, -8.44 to -1.65 [P=0.004]; n=6 studies; I-2<49%; P for heterogeneity >0.2). No significant difference in no-flow fraction (n=7 studies) or ventilation rate (n=4 studies) was detected between survivors and nonsurvivors. Conclusions-Deeper chest compressions and rates closer to 85 to 100 cpm are significantly associated with improved survival from cardiac arrest.
引用
收藏
页码:148 / 156
页数:9
相关论文
共 50 条
  • [11] Survival of pediatric patients after cardiopulmonary resuscitation for in-hospital cardiac arrest: a systematic review and meta-analysis
    Bimerew, Melaku
    Wondmieneh, Adam
    Gedefaw, Getnet
    Gebremeskel, Teshome
    Demis, Asmamaw
    Getie, Addisu
    ITALIAN JOURNAL OF PEDIATRICS, 2021, 47 (01)
  • [12] Survival of pediatric patients after cardiopulmonary resuscitation for in-hospital cardiac arrest: a systematic review and meta-analysis
    Melaku Bimerew
    Adam Wondmieneh
    Getnet Gedefaw
    Teshome Gebremeskel
    Asmamaw Demis
    Addisu Getie
    Italian Journal of Pediatrics, 47
  • [13] Effects of real-time feedback on cardiopulmonary resuscitation quality on outcomes in adult patients with cardiac arrest: A systematic review and meta-analysis
    Wang, Shao-An
    Su, Chan-Ping
    Fan, Hsien-Yu
    Hou, Wen-Hsuan
    Chen, Yang-Ching
    RESUSCITATION, 2020, 155 : 82 - 90
  • [14] Does extracorporeal cardiopulmonary resuscitation improve survival with favorable neurological outcome in out-of-hospital cardiac arrest? A systematic review and meta-analysis
    Pagura, Linda
    Fabris, Enrico
    Rakar, Serena
    Gabrielli, Marco
    Mazzaro, Enzo
    Sinagra, Gianfranco
    Stolfo, Davide
    JOURNAL OF CRITICAL CARE, 2024, 84
  • [15] Survival outcome among patients with out-of-hospital cardiac arrest who received cardiopulmonary resuscitation in China: a systematic review and meta-analysis
    Zhou, Guozhong
    Wang, Yan
    Sun, Zihong
    Yuan, Mingqi
    Ma, Yunlin
    Wu, Qianxi
    Wu, Chunyan
    Xu, Jing
    Li, Yongyi
    Liu, Yunchuan
    Wang, Zhenzhou
    Song, Chao
    EUROPEAN JOURNAL OF MEDICAL RESEARCH, 2023, 28 (01)
  • [16] Survival outcome among patients with out-of-hospital cardiac arrest who received cardiopulmonary resuscitation in China: a systematic review and meta-analysis
    Guozhong Zhou
    Yan Wang
    Zihong Sun
    Mingqi Yuan
    Yunlin Ma
    Qianxi Wu
    Chunyan Wu
    Jing Xu
    Yongyi Li
    Yunchuan Liu
    Zhenzhou Wang
    Chao Song
    European Journal of Medical Research, 28
  • [17] Cardiac arrest in the workplace and its outcome: a systematic review and meta-analysis
    Descatha, Alexis
    Dagrenat, Celine
    Cassan, Pascal
    Jost, Daniel
    Loeb, Thomas
    Baer, Michel
    RESUSCITATION, 2015, 96 : 30 - 36
  • [18] Extracorporeal cardiopulmonary resuscitation for cardiac arrest: A systematic review
    Holmberg, Mathias J.
    Geri, Guillaume
    Wiberg, Sebastian
    Guerguerian, Anne-Marie
    Donnino, Michael W.
    Nolan, Jerry P.
    Deakin, Charles D.
    Andersen, Lars W.
    RESUSCITATION, 2018, 131 : 91 - 100
  • [19] A Comparison between Conventional and Extracorporeal Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis
    Alfalasi, Reem
    Downing, Jessica
    Cardona, Stephanie
    Lowie, Bobbi-Jo
    Fairchild, Matthew
    Chan, Caleb
    Powell, Elizabeth
    Pourmand, Ali
    Grazioli, Alison
    Tran, Quincy K.
    HEALTHCARE, 2022, 10 (03)
  • [20] How effective is extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest? A systematic review and meta-analysis
    Downing, Jessica
    Al Falasi, Reem
    Cardona, Stephanie
    Fairchild, Matthew
    Lowie, Bobbi
    Chan, Caleb
    Powell, Elizabeth
    Pourmand, Ali
    Tran, Quincy K.
    AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2022, 51 : 127 - 138