Cardiac & Resuscitation, Exclusives, Heart of America, Patient Care, Top Story

Mechanical CPR: A Critical Element in Any Cardiac Arrest Bundle of Care

Mechanical CPR devices (mCPR) provide automated chest compressions during cardiac arrest. High-performance CPR improves survival, and mechanical CPR has multiple advantages over manual CPR: consistent compressions, “cognitive offloading,” effective CPR during patient transport and crew safety, as well as the ability to provide PCI/ECMO during CPR, the need for less rescuers and decreased CPR pauses.

Published data showing the errors in the performance of CPR are common, and research has shown that proper CPR rate and depth improve survival.1 At present, there are no mCPR devices that actively decompress the chest during the chest recoil phase—this kind of advancement is needed to further optimize outcomes during CPR.

Multiple trials and systematic reviews have shown that mCPR achieves similar outcomes to manual CPR but isn’t superior.2,3 However, none of these trials had implemented a full bundle of care for cardiac arrest.

Cardiac arrest bundles of care that take into account the best tools and techniques are showing that we can maximize survival with telephone CPR instructions; early citizen CPR and defibrillation; high-performance CPR; mCPR that consistently compresses the chest at the correct rate and depth without fatigue, allows for full chest recoil and significantly reduces interruptions in compressions; use of an impedance threshold device; proper ventilation; therapeutic hypothermia; early PCI/ECMO; transport to cardiac arrest centers of excellence; expert ICU care; and data collection and analysis.

Therefore, mCPR devices are essential and critical to improving survival in any bundle of care for cardiac arrest, especially when prolonged CPR or CPR during transport are needed.

References

1. Idris AH, Guffey D, Pepe PE, et al. Chest compression rates and survival following out-of-hospital cardiac arrest. Crit Care Med. 2015:43(4):840–848.

2. Li H, Wang D, Yu Y, et al. Mechanical versus manual chest compressions for cardiac arrest: A systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med. 2016;24:10.

3. Gates S, Quinn T, Deakin CD, et al. Mechanical chest compression for out of hospital cardiac arrest: Systematic review and meta-analysis. Resuscitation. 2015;94:91–97.