Kim Wonhee, Ahn Chiwon, Kim In-Young, Choi Hyun-Young, Kim Jae-Guk, Kim Jihoon, Shin Hyungoo, Moon Shinje, Lee Juncheol, Lee Jongshill, Cho Youngsuk, Lee Yoonje, Shin Dong-Geum
Department of Emergency Medicine, College of Medicine, Hallym University, Chuncheon 24252, Korea.
Department of Biomedical Engineering, College of Medicine, Hanyang University, Seoul 04763, Korea.
Medicina (Kaunas). 2022 Feb 27;58(3):353. doi: 10.3390/medicina58030353.
: This study analyzed the prognostic impact of mechanical cardiopulmonary resuscitation (CPR) devices in out-of-hospital cardiac arrest (OHCA) patients, in comparison to manual CPR. : This study was a nationwide population-based observational study in South Korea. Data were retrospectively collected from 142,905 OHCA patients using the South Korean Out-of-Hospital Cardiac Arrest Surveillance database. We included adult OHCA patients who received manual or mechanical CPR in the emergency room. The primary outcome was survival at discharge and the secondary outcome was sustained return of spontaneous circulation (ROSC). Statistical analysis included propensity score matching and multivariate logistic regression. : A total of 19,045 manual CPR and 1125 mechanical CPR cases (671 AutoPulse vs. 305 Thumper vs. 149 LUCAS) were included. In the matched multivariate analyses, all mechanical CPR devices were associated with a lower ROSC than that of manual CPR. AutoPulse was associated with lower survival in the multivariate analysis after matching (aOR with 95% CI: 0.57 (0.33-0.96)), but the other mechanical CPR devices were associated with similar survival to discharge as that of manual CPR. Witnessed arrest was commonly associated with high ROSC, but the use of mechanical CPR devices and cardiac origin arrest were associated with low ROSC. Only target temperature management was the common predictor for high survival. : The mechanical CPR devices largely led to similar survival to discharge as that of manual CPR in OHCA patients; however, the in-hospital use of the AutoPulse device for mechanical CPR may significantly lower survival compared to manual CPR.
本研究分析了与徒手心肺复苏（CPR）相比，机械心肺复苏设备对院外心脏骤停（OHCA）患者预后的影响。本研究是一项基于韩国全国人口的观察性研究。使用韩国院外心脏骤停监测数据库，回顾性收集了142,905例OHCA患者的数据。我们纳入了在急诊室接受徒手或机械CPR的成年OHCA患者。主要结局是出院时存活，次要结局是自主循环恢复（ROSC）持续。统计分析包括倾向得分匹配和多变量逻辑回归。共纳入19,045例徒手CPR和1125例机械CPR病例（671例AutoPulse、305例Thumper和149例LUCAS）。在匹配的多变量分析中，所有机械CPR设备的ROSC均低于徒手CPR。匹配后的多变量分析中，AutoPulse与较低的存活率相关（调整后比值比及95%置信区间：0.57（0.33 - 0.96）），但其他机械CPR设备与徒手CPR出院时的存活率相似。目击心脏骤停通常与高ROSC相关，但使用机械CPR设备和心源性心脏骤停与低ROSC相关。仅目标温度管理是高存活率的常见预测因素。在OHCA患者中，机械CPR设备在很大程度上导致与徒手CPR相似的出院存活率；然而，与徒手CPR相比，在医院内使用AutoPulse设备进行机械CPR可能会显著降低存活率。
