Mechanical CPR gaining popularity despite lack of evidence

The U.S. is seeing an uptick in the use of mechanical resuscitation devices despite a paucity of evidence that the digitized CPR tools are effective, researchers reported in JAMA Network Open this fall.

Taeho Greg Rhee, PhD, alongside colleagues at Yale University and the University of California, San Francisco, found that while manual CPR is still performed in the majority of cases of out-of-hospital cardiac arrest (OHCA)—about 69% of the time—mechanical CPR devices are becoming more popular among EMTs. According to Rhee, a combination of rising OHCA rates and anecdotal evidence of an increase in the use of mechanical resuscitation devices was what pushed the team to pursue their study.

The authors pulled information from the National Emergency Medical Services Information System database for their work, ultimately identifying 892,022 patients who experienced an OHCA between 2010 and 2016. The data revealed a fourfold increase in the use of mechanical CPR devices over the six-year period.

While manual CPR was still performed in more than two-thirds of cases, Rhee and colleagues reported that the use of mechanical devices rose “steeply” between 2010 and 2016—from around 2% to 8%.

“It was particularly surprising because the mechanical CPR has not been tested for effectiveness by the FDA, even though it was approved by the FDA,” Rhee, of UConn Health, said in a release. “We don’t really know if it is effective in terms of keeping people alive and whether it is cost-effective.”

And mechanical resuscitation does have a hefty price tag, often costing centers upwards of $10,000 per unit.

“Given the high costs of mechanical CPR devices, better evidence is needed to determine whether these devices improve clinically meaningful outcomes for patients treated for out-of-hospital cardiac arrest by emergency services professionals to justify the significant increase in their use,” Rhee said.

He noted that the mechanical approach might have increased in popularity in recent years due to heavy marketing by medical device companies, but said more research needs to be done to determine how effective those devices really are compared to manual CPR.

“This is more like an initial step to build further research on mechanical CPR used outside of the hospital setting,” Rhee said.