Mechanical CPR no better than manual

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 - CPR

The use of a mechanical cardiopulmonary resuscitation (CPR) machine offered no survival advantage over manual CPR in a European study published in the Jan. 1 issue of JAMA. There was no significant difference in four-hour survival between the two types of resuscitation and neurological outcomes were good six months later in both groups.

In the LUCAS in Cardiac Arrest (LINC) study, researchers from Sweden, the U.K. and the Netherlands randomized more than 2,500 patients who suffered a heart attack outside the hospital to receive mechanical chest compressions with the LUCAS Chest Compression System (Physio-Control/Jolife AB) along with defibrillation during compressions or to manual CPR. Patients were enrolled between 2008 and 2012. The primary outcome was four-hour survival and secondary outcomes were survival up to six months with good neurological outcomes using the Cerebral Performance Category (CPC) score. A good outcome was defined as a score of 1 or 2.

There was no significant difference in four-hour survival between the two groups (23.6 percent for the LUCAS device vs. 23.7 percent for manual CPR). Rates of six-month survival with good neurological outcomes were similar between the groups as well—7.5 percent vs. 6.4 percent of patients discharged from the intensive care unit; 8.3 percent vs. 7.8 percent of patients discharged from the hospital; 8.1 percent vs. 7.3 percent at one month and 8.5 percent vs. 7.6 percent at six months. Of the patients who survived six months after discharge, 99 percent of the device CPR and 94 percent of the manual CPR group had good neurological outcomes.

The authors, led by Sten Rubertsson, MD, PhD, of Uppsala University in Uppsala, Sweden, concluded that “CPR with this mechanical device using the presented algorithm can be delivered without major complications but did not result in improved outcomes compared with manual chest compressions.”

Physio-Control/Jolife AB provided the LUCAS device and some funding for this study.