A Systematic Review and Meta-Analysis of Manual and Mechanical Chest Compressions in Prehospital Cardiac Arrest Patients

Presenter

Caitlin Daly

Campus

Salem State University

Sponsor

Jason Gillis, Department of Exercise Science, Salem State University

Schedule

Session 3, 1:30 PM - 2:15 PM [Schedule by Time][Poster Grid for Time/Location]

Location

Poster Board A61, Campus Center Auditorium, Row 4 (A61-A80) [Poster Location Map]

Abstract

Background: The purpose of this study is to assess the effects, both benefits and harms, of manual cardiopulmonary resuscitation compared with mechanical cardiopulmonary resuscitation for sudden out‐of‐hospital cardiac arrest in adults. Mechanical chest compression devices are intended to be used as an adjunct to CPR and perform chest compressions in place of a human responder. Human providers must apply and calibrate these devices prior to initiating automatic compressions. Many EMS systems train for team focused CPR which requires 6 providers. If a mechanical device is performing compressions then a team of 4 providers could effectively perform team focused CPR while limiting rescuer fatigue and preventing interruptions in compressions. Since the mechanical device automatically performs compressions, providers are free to focus on other interventions related to the resuscitation, packaging, and transport of the patient.  Past reviews exist comparing conventional CPR with manual chest compressions and device assisted CPR with mechanical chest compressions. Some of these reviews presented with notable differences between the protocol and review. The differences between the original protocol and final review were justified citing insufficient data. The data collection phase did not yield enough studies to conduct a full systematic review and meta-analysis. The review appears to have missed what may be key papers as well. The protocol was published in 2008, and the review in 2018. In the last 6 years more studies have been published that have the potential to be influential in this Systematic Review and meta-analysis (SRM). It is important to conduct an SRM to address the insufficient data and missing papers. Method: Following Cochrane guidelines, we will systematically search databases with key terms, using Zotero for reference management, and to identify relevant studies, remove duplicates and retracted articles, and screen for eligibility based on predefined criteria. Full-text assessments will further refine the selection, with data extraction. Statistical analysis will be conducted using Excel for data organization and R for meta-analysis, including effect size calculation and heterogeneity assessment with 'Metafor' and related packages. Sensitivity analyses and the GRADE framework will evaluate the robustness of findings and evidence certainty, considering biases and inconsistencies. The process aims to ensure a transparent, rigorous synthesis of evidence on the topic. Results: Data collection is currently underway, with data processing and analysis starting in mid-march, followed by presentation of tentative results by early April.

Keywords

mechanical cardiopulmonary resuscitation , sudden cardiac death, blood circulation

Research Area

Medical Sciences

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