Mechanical chest-compression devices: current and future roles.
OBJECTIVE
It is recognized that the quality of cardiopulmonary resuscitation (CPR) is an important predictor of outcome from cardiac arrest yet studies consistently demonstrate that the quality of CPR performed in real life is frequently sub-optimal. Mechanical chest-compression devices provide an alternative to manual CPR. This review will consider the evidence and current indications for the use of these devices.


RESULTS
Physiological and animal data suggest that mechanical chest-compression devices are more effective than manual CPR. However, there is no high quality evidence showing improved outcomes in humans. There are specific circumstances where it may not be possible to perform manual CPR effectively for example, during ambulance transport to hospital, en-route to and during cardiac catheterization, prior to organ donation and during diagnostic imaging where using these devices may be advantageous.


CONCLUSIONS
There is insufficient evidence to recommend the routine use of mechanical chest-compression devices. There may be specific circumstances when CPR is difficult or impossible where mechanical devices may play an important role in maintaining circulation. There is an urgent need for definitive clinical and cost effectiveness trials to confirm or refute the place of mechanical chest-compression devices during resuscitation.
Perkins
Gavin D
GD
University of Warwick, UK. g.d.perkins@warwick.ac.uk <g.d.perkins@warwick.ac.uk>
Brace
Samantha
S
Gates
Simon
S
D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D004867:Equipment Design / Q000295:instrumentation; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans