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Evaluating the Efficacy and Safety of the Thumper Device for Cardiac Arrest: A Systematic Literature Review and
Ding Luo1,2,3, Yuji Weng4, Na Zhang1,2
1International Nursing School of Hainan Medical University, 571199 Haikou, Hainan, China.
Insights
The Thumper device significantly improves survival rates and return of spontaneous circulation in cardiac arrest patients compared to manual cardiopulmonary resuscitation. It also reduces the incidence of rib fractures, suggesting a beneficial role for mechanical chest compressions in hospital settings.
Area of Science:
- Emergency Medicine
- Cardiology
- Critical Care Medicine
Background:
- Cardiopulmonary resuscitation (CPR) is vital for cardiac arrest (CA) patients, with chest compressions being a critical component.
- The Thumper device aims to enhance manual chest compressions during CPR.
- Existing randomized controlled trials (RCTs) on the Thumper device's efficacy yield conflicting results.
Purpose of the Study:
- To conduct a meta-analysis comparing the clinical benefits of Thumper device-assisted CPR versus manual chest compressions for CA patients.
- To evaluate the impact of the Thumper device on key resuscitation outcomes.
Main Methods:
- A systematic literature search was performed across multiple databases (Ovid, PubMed, Web of Science, EMBASE, Cochrane, CNKI) and reference lists.
- Included were RCTs published in English or Chinese up to June 31, 2020.
- Odds ratios (ORs) and 95% confidence intervals (CIs) for return of spontaneous circulation (ROSC), survival rate (SR), and rib fractures (RFs) were compared.
Main Results:
- 16 RCTs involving 2164 records were analyzed, with risk of bias rated low to medium.
- Thumper chest compressions showed significantly better outcomes: ROSC (OR 2.56, 95% CI 2.11-3.11), SR (OR 4.06, 95% CI 2.77-5.93).
- The incidence of rib fractures was significantly lower with Thumper device use (OR 0.24, 95% CI 0.14-0.41).
Conclusions:
- Thumper compression devices may enhance patient outcomes in in-hospital cardiac arrest scenarios.
- Mechanical chest compression devices show potential for in-hospital CA management.
- High-quality, adequately powered randomized trials are urgently needed to further validate these findings.
Background:
Cardiopulmonary resuscitation (CPR) is a major rescue measure for cardiac arrest (CA) patients, and chest compression is the key to CPR. The Thumper device was designed to facilitate manual compression during CPR. However, current randomized controlled trials (RCTs) provide controversial findings on the efficacy of the Thumper device.
Objectives:
This meta-analysis aimed to compare the clinical benefits of using the Thumper device with manual chest compressions during the provision of CPR for patients in CA.
Methods:
Relevant studies were retrieved from various databases, including Ovid, PubMed, Web of Science, EMBASE, Cochrane, and CNKI, and by manually searching the reference lists of research and review articles. All RCTs published in either English or Chinese until June 31, 2020, were included in the meta-analysis. The odds ratios (ORs) and their 95% confidence intervals (95% CIs) for the return of spontaneous circulation (ROSC), survival rate (SR), and the incidence of rib fractures (RFs) were compared between the manual and Thumper chest compressions.
Results:
A total of 2164 records were identified, of which 16 were RCTs with an overall risk of bias ranging from low to medium classification. Following CPR, the odds ratios for ROSC, SR, and RF were significantly better for the Thumper chest compression with ORs of 2.56 (95% CI 2.11-3.11, = 0%), 4.06 (95% CI 2.77-5.93, = 0%), and 0.24 (95% CI 0.14-0.41, = 0%), respectively.
Conclusions:
The Thumper compression devices may improve patient outcome, when used at inhospital cardiac arrest. This review suggests a potential role for mechanical chest compression devices for in-hospital cardiac arrest, but there is an urgent need for high-quality research, particularly adequately powered randomised trials, to further examine this role.
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