Influence of Personal Protective Equipment on the Quality of Chest Compressions: A Meta-Analysis of Randomized Controlled Trials.
Frontiers in Medicine · 2021-01-01 · Meta-analysis
Abstract
Background: Randomized controlled trials (RCTs) evaluating the influence of personal protective equipment (PPE) on quality of chest compressions during cardiopulmonary resuscitation (CPR) showed inconsistent results. Accordingly, a meta-analysis was performed to provide an overview. Methods: Relevant studies were obtained by search of Medline, Embase, and Cochrane's Library databases. A random-effect model incorporating the potential heterogeneity was used to pool the results. Results: Six simulation-based RCTs were included. Overall, pooled results showed that there was no statistically significant difference between the rate [mean difference (MD): -1.70 time/min, 95% confidence interval (CI): -5.77 to 2.36, P = 0.41, I 2 = 80%] or the depth [MD: -1.84 mm, 95% CI: -3.93 to 0.24, P = 0.11, I 2 = 73%] of chest compressions performed by medical personnel with and without PPE. Subgroup analyses showed that use of PPE was associated with reduced rate of chest compressions in studies before COVID-19 (MD: -7.02 time/min, 95% CI: -10.46 to -3.57, P < 0.001), but not in studies after COVID-19 (MD: 0.14 time/min, 95% CI: -5.77 to 2.36, P = 0.95). In addition, PPE was not associated with significantly reduced depth of chest compressions in studies before (MD: -3.34 mm, 95% CI: -10.29 to -3.62, P = 0.35) or after (MD: -0.97 mm, 95% CI: -2.62 to 0.68, P = 0.25) COVID-19. No significant difference was found between parallel-group and crossover RCTs (P for subgroup difference both > 0.05). Conclusions: Evidence from simulation-based RCTs showed that use of PPE was not associated with reduced rate or depth of chest compressions in CPR.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Related articles
- Effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes: A systematic review. (Resusc Plus, 2023)
- Impact of personal protective equipment on the effectiveness of chest compression - A systematic review and meta-analysis. (Am J Emerg Med, 2021)
- The quality of CPR delivered by EMS personnel wearing enhanced personal protective equipment during the COVID-19 pandemic: a retrospective cohort study from Perth, Australia. (Resusc Plus, 2025)
- Use of personal protective equipment and cognitive load during cardiopulmonary resuscitation - A randomized cross-over simulation-based study. (Resusc Plus, 2025)
- Chest compression quality comparing 1-min vs 2-min rotation of rescuers wearing N95 masks. (Am J Emerg Med, 2024)
- Impact of Personal Protective Equipment on the Quality of Chest Compressions in Prehospital Care: A Prospective Randomized Crossover Study. (Prehosp Disaster Med, 2023)