Tag Archive for: Mechanical CPR

Episode 34 – The Death of Mechanical CPR (mCPR)?

23 Mar
March 23, 2017

Background: The two most important things that we can do in cardiac arrest to improve survival and neurologically intact outcomes is high quality CPR, with limited interruptions and early defibrillation. In the case of the former, the 2015 AHA/ACC CPR updates recommended a compression rate of 100 -120/min, a depth of 2 – 2.4in, allowing full recoil, and minimizing pauses. This is a lot to remember during a stressful code situation and one way many providers are offloading themselves cognitively is by the use of mechancical CPR (mCPR) devices.  In theory these devices compress at a fixed rate, and depth, with the added benefit that the machine simply does not tire out.  Additionally, use of this device allows another provider to be available for other procedures and interventions. A recent systematic review and meta-analysis in  looked at five randomized clinical trials with over 10,000 patients with out-of-hospital cardiac arrest (OHCA) (Gates 2015).  They concluded that there was no difference in ROSC, survival or survival with good neurological outcomes with the use of these devices compared to manual CPR. It is important to state that none of these studies showed increased harm either.  A new paper just published in Circulation however, argues that mCPR during OHCA was associated with lower neurologically intact survival. Read more →

CPR in Out of Hospital Cardiac Arrest: Man vs Machine

26 Oct
October 26, 2015

CPR - Man vs MachineBackground: In cardiac arrest, high quality, uninterrupted CPR is essential to help improve survival rates. In theory, mechanical CPR should provide CPR at a standard depth and rate for prolonged periods without a decline in quality, which should help improve survival and survival with good neurologic outcomes. There are many types of mechanical chest compression devices but the two main technologies can be generalized as piston devices and load-distributing bands. The piston driven devices work by compressing on the chest in an up and down type of motion, similar to how we do manual CPR. The load distributing bands wrap all the way around the chest and shorten and lengthen which provides more of a rhythmic type of chest compression. No individual trials have ever shown superiority on clinically important outcomes for adult patients with OHCA, regardless of device. Read more →

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