title: Mechanical chest compression for out of hospital cardiac arrest: Systematic review and meta-analysis.
abstract: OBJECTIVE
  To summarise the evidence from randomised controlled trials of mechanical chest compression devices used during resuscitation after out of hospital cardiac arrest.
  
  
  METHODS
  Systematic review of studies evaluating the effectiveness of mechanical chest compression. We included randomised controlled trials or cluster randomised trials that compared mechanical chest compression (using any device) with manual chest compression for adult patients following out-of-hospital cardiac arrest. Outcome measures were return of spontaneous circulation, survival of event, overall survival, survival with good neurological outcome. Results were combined using random-effects meta-analysis.
  
  
  METHODS
  Studies were identified by searches of electronic databases, reference lists of other studies and review articles.
  
  
  RESULTS
  Five trials were included, of which three evaluated the LUCAS or LUCAS-2 device and two evaluated the AutoPulse device. The results did not show an advantage to the use of mechanical chest compression devices for survival to discharge/30 days (average OR 0.89, 95% CI 0.77, 1.02) and survival with good neurological outcome (average OR 0.76, 95% CI 0.53, 1.11).
  
  
  CONCLUSIONS
  Existing studies do not suggest that mechanical chest compression devices are superior to manual chest compression, when used during resuscitation after out of hospital cardiac arrest.
authors.affiliation: Warwick Clinical Trials Unit, University of Warwick, Coventry CV4 7AL, UK. Electronic address: s.gates@warwick.ac.uk.
authors.forename: Simon
authors.initials: S
authors.lastname: Gates
authors.affiliation: School of Health Sciences, Faculty of Health and Medical Sciences, Duke of Kent Building, University of Surrey, Guildford GU2 7XH, UK; Surrey Perioperative, Anaesthetic and Critical Care Collaborative Research Group, Surrey Health Partners, Egerton Road, Guildford GU2 8DR, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Quinn
authors.affiliation: South Central Ambulance Service NHS Foundation Trust, Otterbourne, UK; NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
authors.forename: Charles D
authors.initials: CD
authors.lastname: Deakin
authors.affiliation: North East Ambulance Service NHS Foundation Trust, Bernicia House, Goldcrest Way, Newburn Riverside, Newcastle upon Tyne NE15 8NY, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Blair
authors.affiliation: Warwick Clinical Trials Unit, University of Warwick, Coventry CV4 7AL, UK; Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Couper
authors.affiliation: Warwick Clinical Trials Unit, University of Warwick, Coventry CV4 7AL, UK.
authors.forename: Gavin D
authors.initials: GD
authors.lastname: Perkins
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D011312:Pressure; D013909:Thorax
keywords: AutoPulse; Cardiac arrest; Cardiopulmonary resuscitation; LUCAS; Mechanical chest compression