Manual mastery vs. mechanized magic: current opinions on manual vs. mechanical chest compressions

Mechanical chest compression devices are increasingly deployed during cardiopulmonary resuscitation. We discuss the data supporting the use of mechanical chest compression devices during cardiac arrest and provide an opinion about the future of the technology.

Multiple randomized trials investigating the use of mechanical chest compression devices for out-of-hospital cardiac arrest have not demonstrated improved outcomes. There is little prospective evidence to support the use of mechanical chest compression devices in other settings. Data from observational studies do not support the routine use of mechanical chest compression devices for in-hospital cardiac arrest, but there may be a role for mechanical chest compressions for cardiac arrest in procedural areas and cardiac arrest prior to cannulation for extracorporeal membrane oxygenation.

Mechanical chest compression devices offer a solution to some of the human limiting factors of resuscitation, but have failed to demonstrate meaningful improvement in outcomes from cardiac arrest. Routine use of mechanical chest compression devices during cardiac arrest is not supported by evidence.