Evaluating the Efficacy and Safety of the Thumper Device for Cardiac Arrest: A Systematic Literature Review and Meta-Analysis.

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.