Luo Ding, Weng Yuji, Zhang Na, Xu Baichao, Zhang Hua, Wang Jiameng
International Nursing School of Hainan Medical University, 571199 Haikou, Hainan, China.
Key Laboratory of Emergency and Trauma, Ministry of Education, 571199 Haikou, Hainan, China.
Rev Cardiovasc Med. 2023 Jul 3;24(7):191. doi: 10.31083/j.rcm2407191. eCollection 2023 Jul.
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.
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.
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.
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.
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.
心肺复苏术（CPR）是心脏骤停（CA）患者的主要抢救措施，而胸外按压是心肺复苏术的关键。Thumper设备旨在便于在心肺复苏术中进行手动按压。然而，目前的随机对照试验（RCT）对Thumper设备的疗效给出了有争议的结果。
本荟萃分析旨在比较在为CA患者进行心肺复苏时使用Thumper设备与手动胸外按压的临床益处。
从多个数据库检索相关研究，包括Ovid、PubMed、科学网、EMBASE、Cochrane和中国知网，并通过手动搜索研究和综述文章的参考文献列表。纳入截至2020年6月31日发表的所有英文或中文随机对照试验进行荟萃分析。比较手动胸外按压和Thumper胸外按压之间自主循环恢复（ROSC）、生存率（SR）和肋骨骨折发生率（RF）的比值比（OR）及其95%置信区间（95%CI）。
共识别出2164条记录，其中16项为随机对照试验，总体偏倚风险为低至中度分类。心肺复苏后，Thumper胸外按压的ROSC、SR和RF的比值比显著更好，分别为2.56（95%CI 2.11 - 3.11，P = 0%）、4.06（95%CI 2.77 - 5.93，P = 0%）和0.24（95%CI 0.14 - 0.41，P = 0%）。
Thumper按压设备用于院内心脏骤停时可能改善患者预后。本综述表明机械胸外按压设备在院内心脏骤停中可能发挥作用，但迫切需要高质量研究，尤其是有足够样本量的随机试验，以进一步探究这一作用。
