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Cardiac arrest & resuscitation

Mechanical chest compression versus manual chest compression for cardiopulmonary resuscitation for cardiac arrest patients: A systematic review and meta‐analysis

Yuduo Pu, Haoyu Hou, Zhiming You, Qike Li, Zihan Yu, Siyu He, Chengxin Xue, Chengli Wen, Bo Yang

Hong Kong Journal of Emergency Medicine · 2025-12-01 · Meta-analysis

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Abstract

Abstract Background Cardiac arrest (CA) is high‐risk for death and hard to rescue. There are two methods of chest compression: mechanical and manual. However, it remains unclear which provides better outcomes for patients. Therefore, we perform a systematic review and meta‐analysis for the efficacy of the two methods for CA patients. Method Randomized controlled trials (RCTs) and nonrandomized controlled trials (non‐RCTs) were searched from the Cochrane Library, PubMed, EMBASE, and Web of Science from the date of their establishment to 2 March 2024. RCTs were evaluated using Cochrane randomized trial bias risk tool and the Newcastle–Ottawa Scale for non‐RCTs. All statistical analyses were performed using Stata v18.0 and Review Manager v5.4. Results Twenty‐four studies included 10 RCTs and 14 non‐RCTs, and 224,245 CA patients. Manual extracorporeal cardiopulmonary resuscitation (CPR) may benefit CA patients in achieving return of spontaneous circulation (ROSC) (odds ratio [OR] = 0.90; 95% CI: 0.813–0.996; Z = −2.04; p = 0.04), admission survival rate (OR = 0.87; 95% CI: 0.80–0.94; Z = −3.64; p < 0.05), and discharge survival rate (OR = 0.80; 95% CI: 0.66–0.98; Z = −2.21; p = 0.03). However, there was no significant difference in 30‐day survival rate (OR = 0.80; 95% CI: 0.43–1.48; Z = −0.72; p = 0.47), good restoration of neurologic functions (OR = 0.79; 95% CI: 0.60–1.05; Z = −1.46; p = 0.15), and complication rate (OR = 0.91; 95% CI: 0.47–1.75; Z = −0.29; p = 0.78). Conclusion Manual CPR showed advantages in ROSC, admission survival rate, and discharge survival rate, whereas there was no significant difference in 30‐day survival rate, good recovery of neurological function, and complication compared with mechanical chest compression. Compared with previous systematic reviews and meta‐analyses, this study is the first to report the advantages of manual CPR in ROSC. Large sample size and high‐quality RCTs are needed, as the existing evidence primarily comes from non‐RCTs.

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Tags

Mortality & survival · Quality of life & function · Mechanical CPR

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