Meta-Analysis of Chest Compression-Only Versus Conventional Cardiopulmonary Resuscitation by Bystanders for Adult with Out-of-Hospital Cardiac Arrest

Authors

Karol Bielski
Jacek Smereka
Jaroslaw Chmielewski
Michal Pruc
Francesco Chirico
Aleksandra Gasecka
Nataliia Litvinova
Milosz J Jaguszewski
Grazyna Nowak-Starz
Zubaid Rafique
Frank W Peacock
Lukasz Szarpak

Publication Date

1-1-2023

Journal

Journal of the American College of Cardiology

DOI

10.5603/CJ.a2021.0115

PMID

34622436

PMCID

PMC10508072

PubMedCentral® Posted Date

8-31-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Adult, Out-of-Hospital Cardiac Arrest, Cardiopulmonary Resuscitation, Hospitalization, Patient Discharge, Return of Spontaneous Circulation, out-of-hospital cardiac arrest, cardiopulmonary resuscitation, chest compression, continuous compressions

Abstract

BACKGROUND: According to the guidelines of cardiopulmonary resuscitation (CPR) conducted by bystanders, two methods of CPR are feasible: standard CPR (sCPR) with mouth-to-mouth ventilations and continuous chest compression-only CPR (CCC) without rescue breathing. The goal herein, was to evaluate the effect of sCPR (30:2) and CCC on resuscitation outcomes in patients with out-of-hospital cardiac arrest (OHCA) patients.

METHODS: This study was a systematic review and meta-analysis. Using standardized criteria, Pub- Med, Web of Science, Scopus, EMBASE and Cochrane Collaboration were searched for trials assessing the effect of sCPR vs. CCC on resuscitation outcomes after adult OHCA. Random-effects model meta-analysis was applied to calculate the mean deviation (MD), odds ratio (OR) and 95% confidence interval (CI).

RESULTS: Overall, 3 randomized controlled trials and 12 non-randomized trials met the inclusion criteria. Survival to hospital discharge with sCPR was 10.2% compared to 9.3% in the CCC group (OR = 1.04; 95% CI: 0.93-1.16; p = 0.46). Survival to hospital discharge with good neurological outcome measured with the cerebral performance category (CPC 1 or 2) was 6.5% for sCPR vs. 5.8% for CCC (OR = 1.00; 95% CI: 0.84-1.20; p = 0.98). Prehospital return of spontaneous circulation (ROSC) in sCPR and CCC groups was 15.9% and 14.8%, respectively (OR = 1.13; 95% CI: 0.91-1.39; p = 0.26). Survival to hospital admission with ROSC occurred in 29.5% of the sCPR group compared to 28.4% in CCC group (OR = 1.20; 95% CI: 0.89-1.63; p = 0.24).

CONCLUSIONS: This systematic review and meta-analysis concluded that there were no significant differences in the resuscitation outcomes between the use of standard cardiopulmonary resuscitation and chest compression only.