title: Meta-analysis of outcomes of the 2005 and 2010 cardiopulmonary resuscitation guidelines for adults with in-hospital cardiac arrest.
abstract: OBJECTIVE
  The post-cardiac arrest survival rate has remained low since the 2010 cardiopulmonary resuscitation (CPR) guidelines were published. The present study aimed to review the 2010 vs 2005 CPR guideline outcomes in adults with in-hospital cardiac arrest.
  
  
  METHODS
  The Pub Med, EMBASE, and Cochrane Library databases were searched for articles published between January 2006 and July 2015. We extracted the following from observational studies and intervention studies: first author's name, publication year, study duration, age of study population, and sample size. The primary outcome variables were return of spontaneous circulation (ROSC) and survival to discharge. The data were divided into 2005 (data collected before December 2010) and 2010 (data collected in December 2010 or later) CPR guidelines groups.
  
  
  RESULTS
  Twenty-four original articles (77,605 patients) were included. Statistically significant heterogeneity (ROSC: P<.01, I(2)=97.9%; survival to discharge: P<.01, I(2)=98.3%) was seen, and a random-effects model was used to pool the outcomes. The pooled ROSC rate for the 2010 group (n=5; mean, 48%; 95% confidence interval [CI], 0.38-0.58) was only slightly higher than that of the 2005 group (n=19; mean, 47%; 95% CI, 0.38-0.57). The opposite result was noted in the pooled survival to discharge rates (2010: n=5, mean, 14%; 95% CI, 0.08-0.20 vs 2005: n=19; mean, 15%; 95% CI, 0.10-0.20). There was actually no significant difference in ROSC or survival to discharge outcomes between the 2 groups.
  
  
  CONCLUSIONS
  The 2010 CPR guidelines emphasized that high-quality chest compressions can increase the ROSC rate but did not show to improve long-term results.
authors.affiliation: Nursing School of Central South University, Tongzipo Rd No. 172, Changsha, Hunan, 410013, China; Department of Emergency, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
authors.forename: Aiqun
authors.initials: A
authors.lastname: Zhu
authors.affiliation: Nursing School of Central South University, Tongzipo Rd No. 172, Changsha, Hunan, 410013, China. Electronic address: jpzhang1965@csu.edu.cn.
authors.forename: Jingping
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001775:Blood Circulation; D016887:Cardiopulmonary Resuscitation; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D064887:Observational Studies as Topic; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome; D055815:Young Adult