The effect of team-based CPR on outcomes in out of hospital cardiac arrest patients: A meta-analysis

Objectives: The objective of this systematic review and meta-analysis was to determine the effects of team cardio-pulmonary resuscitation (CPR) on outcomes of patients with out-of-hospital cardiac arrest (OHCA). Methods: A systematic literature review was performed using PubMed, EMBASE, and the Cochrane database to identify relevant articles for this meta-analysis. All studies that described the implementation of team CPR performed by emergency medical services for OHCA patients with presumed cardiac etiology were included in this study. Outcomes included return of spontaneous circulation (ROSC), survival to hospital discharge, and good neurological recovery. Results: A total of 2504 studies were reviewed. After excluding studies according to exclusion criteria, 4 studies with 15,455 OHCA patients were included in this study. The odds of survival and neurologic recovery for patients who received team CPR were higher than those for patients who did not (survival odds ratio [OR]: 1.68; 95% confidence interval [CI]: 1.48-1.91; neurologic recovery OR: 1.52; 95% CI: 1.31-1.77). There was no significant difference in the odds of ROSC between the two patient groups (OR: 1.59; 95% CI: 0.76-3.33). Conclusions: In this meta-analysis, team CPR improved the outcomes of OHCA patients, consistently increasing their odds of survival to discharge and neurologic recovery. (C) 2017 Elsevier Inc. All rights reserved.