Effectiveness of mechanical chest compression for out-of-hospital cardiac arrest patients in an emergency department

Background: To increase the chance of restoring spontaneous circulation, cardiopulmonary resuscitation (CPR) with high-quality chest compressions is needed. We hypothesized that, in a municipal hospital emergency department, the outcome in nontraumatic out-of-hospital cardiac arrest patients treated with standard CPR followed by mechanical chest compression (MeCC) was not inferior to that followed by manual chest compression (MaCC). The purposes of the study were to test our hypothesis and investigate whether the use of MeCC decreased human power demands for CPR. Methods: A total of 455 consecutive out-of-hospital cardiac arrest patients of presumed cardiac etiology were divided into two groups according to the chest compressions they received (MaCC or MeCC) in this retrospective review study. Human power demand for CPR was described according to the Basic Life Support/Advanced Cardiovascular Life Support guidelines and the device handbook. The primary endpoint was recovery of spontaneous circulation during resuscitation, and the secondary endpoints were survival to hospital admission and medical human power demands. Results: In this study, recovery of spontaneous circulation was achieved in 33.3% of patients in the MeCC group and in 27.1% in the MaCC group (p = 0.154), and the percentages of patients who survived hospitalization were 22.2% and 17.6%, respectively (p = 0.229). A ratio of 2:4 for the human power demand for CPR between the groups was found. Independent predictors of survival to hospitalization were ventricular fibrillation/pulseless ventricular tachycardia as initial rhythm and recovery of spontaneous circulation. Conclusion: No difference was found in early survival between standard CPR performed with MeCC and that performed with MaCC. However, the use of the MeCC device appears to promote staff availability without waiving patient care in the human power-demanding emergency departments of Taiwan hospitals. Copyright (C) 2015 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.