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Mechanical CPR: Facts, Numbers, and AHA Guidelines

High-quality CPR is one of the few interventions proven to enhance neurologically intact survival from cardiac arrest. The components of high-quality CPR includes adequate

compression fraction, compression depth, compression rate, chest recoil, and minimizing pre & post-shock pauses.

How many of you make use of Mechanical Compression devices? Devices most commonly use include Autopulse, LUCAS, and others. BUT, do these devices really make a difference in patient outcomes in comparison to conventional CPR??

Between 2004 to 2005 the ASPIRE Trial looked at Mechanical CPR versus Manual Chest compressions. The trial was stopped early and the conclusion was that there were worse neurological outcomes for patients receiving mechanical CPR versus traditional CPR.

One of the recent studies published in Circulation by Buckler et al looked at CARES, a US national registry of out-of-hospital cardiac arrest. Buckler and his team reviewed 80 000 + non-traumatic Adult cardiac arrests between January 2013 to December 2015. The study found that neurological intact survival to hospital discharge for subjects not receiving mechanical CPR was 9.5% versus 5.6% for those who received mechanical CPR. The study showed that mechanical CPR during out-of-hospital cardiac arrest was associated with lower neurologically favorable survival within Emergency Medical serviced agencies participating in CARES.

The use of mechanical devices in specific circumstances (e.g. moving ambulance/helicopter transport, Cathlab, Infectious diseases) where high-quality chest compressions cannot be safely delivered may be a reasonable strategy. In all situations where mechanical devices are used, clinicians must ensure that the device is deployed with minimal interruption to chest compression delivery. During the COVID pandemic, it can be a useful tool where we can minimize the number of clinicians inside a patient room.

2020 AHA Guidelines for CPR and ECC :

🛑 The routine use of mechanical CPR devices is not recommended (COR: 3[No Benefit]; LOE: B-R)

⚠️The use of mechanical CPR devices may be considered in specific setting where the delivery of high-quality manual compressions may be challenging or dangerous for the provider, as long as rescuers strictly limit interruptions in CPR during deployment and removal of the device (COR: 2b; LOE: C-LD)

Bottom Line: Currently these do not increase rates of survival and neurologically intact survival.

This is a topic where Healthcare professionals are very divided.

📷 @simbodiesglobal

Disclaimer: This video is for educational purposes only and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.


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