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Real-world comparison between mechanical and manual cardiopulmonary resuscitation during the COVID-19 pandemic

Hyun Joon Kim1, Dongwook Lee1, Hyung Jun Moon1

  • 1Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Cheonan 31151, Republic of Korea.

The American Journal of Emergency Medicine
|December 21, 2023
PubMed

Insights

Mechanical cardiopulmonary resuscitation (CPR) showed no survival or neurological outcome benefits compared to manual CPR with personal protective equipment (PPE). Mechanical CPR did result in longer resuscitation times in the emergency department.

Area of Science:

  • Emergency Medicine
  • Cardiology
  • Public Health

Background:

  • The COVID-19 pandemic increased out-of-hospital cardiac arrests (OHCA), necessitating personal protective equipment (PPE) use during cardiopulmonary resuscitation (CPR).
  • Mechanical CPR devices were introduced to minimize personnel during resuscitation efforts.

Purpose of the Study:

  • To compare the effectiveness of mechanical CPR versus manual CPR performed by PPE-equipped healthcare providers.
  • To assess survival rates, neurological outcomes, and CPR duration in OHCA patients.

Main Methods:

  • A multicenter observational study using data from the Korean Cardiac Arrest Research Consortium registry.
  • Propensity score matching created two groups: mechanical CPR (n=421) and PPE-equipped manual CPR (n=421) for OHCA patients in emergency departments (EDs) from March 2020 to June 2021.
  • Primary outcomes were survival and favorable neurological outcomes at discharge; secondary outcome was total CPR duration in the ED.

Main Results:

  • No significant differences were observed in survival rates (7.4% vs. 8.3%) or favorable neurological outcomes (3.3% vs. 3.8%) between mechanical and manual CPR groups.
  • The mechanical CPR group experienced a significantly longer duration of CPR within the ED compared to the manual CPR group.

Conclusions:

  • Mechanical CPR did not demonstrate superior outcomes in survival or neurological function compared to manual CPR with PPE in the ED setting.
  • A longer CPR duration was associated with mechanical CPR use.
  • Further research is needed to understand the impact of PPE on healthcare provider performance and fatigue during CPR.
Abstract

Keywords:
COVID-19Cardiopulmonary resuscitationOut-of-hospital cardiac arrestPersonal protective equipment

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