What is the role of mechanical chest compressions in the delivery of cardiopulmonary resuscitation (CPR)?

Updated: Sep 15, 2020
  • Author: Catharine A Bon, MD; Chief Editor: Kirsten A Bechtel, MD  more...
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Some hospitals and emergency medical services (EMS) systems employ devices to provide mechanical chest compressions, although until relatively recently, such devices had not been shown to be more effective than high-quality manual compressions. [32] One study has shown increased survival with better neurologic outcome in patients receiving active compression-decompression CPR with augmentation of negative intrathoracic pressure (achieved with an impedance threshold device), compared with patients receiving standard CPR. [33]

In a meta-analysis of 12 studies, mechanical chest compression devices proved superior to manual chest compressions in the ability to achieve return of spontaneous circulation. In the meta-analysis, Westfall and colleagues found that devices that use a distributing band to deliver chest compression (load-distributing band CPR) was significantly superior to manual CPR (odds ratio, 1.62), while the difference between piston-driven CPR devices and manual resuscitation did not reach significance (odds ratio, 1.25) [34] This finding was supported by a study conducted by Pinto et al. [35]

Additionally, other health systems have begun to implement devices to monitor CPR electronically and provide audiovisual CPR feedback to providers, thereby helping them improve the quality of compressions during CPR. [27, 36, 37, 38]

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