Cardiac arrest & resuscitation
Mechanical chest compression and extracorporeal life support for out-of-hospital cardiac arrest. A 30-month observational study in the metropolitan area of Milan, Italy
Authors' conclusion
MechCPR patients achieved ROSC more frequently than manual CPR patients; mechCPR was a crucial factor in an ECLS protocol for refractory OHCA.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) patients aged 12–75 with no-flow time <20 min, Milan, Italy, 2013–2016108 extracorporeal circulation life support (ECLS)
- Participants
- 1,366 patients
- Exposure
- Mechanical vs manual chest compression for OHCA
- Mechanical chest compression (mechCPR)n = 305
- manCPRn = 1,061reference
- Outcome
- ROSC and CPC ≤2
- Follow-up
- Hospital discharge
Methodological detailsinverse probability of treatment weighting (propensity scores), metropolitan area
- Inverse probability of treatment weighting (propensity scores)
- Metropolitan area
Main finding
As reported in the abstract
ROSC; CPC ≤2
mechCPR vs manCPROdds ratio (95% CI)
ROSC
1.86(1.17–2.96)
CPC ≤2
2.06(1.11–3.81)
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Outcomes in ECLS patients | ECLS Time exceeding protocol 70% · CPC ≤2 8 (7.5%) · Survived with severe neurological disabilities 2 (1.9%) · Brain-dead, organ donors 13 (12.0%) |
- Outcomes in ECLS patients: half of CPC ≤2 with low-flow times between 45 and 90 min
Other factors associated with return of spontaneous circulation (ROSC) and CPC ≤2
- Low-flow minutes, OR (ROSC)
- 0.90 [0.88-0.91]
- Low-flow minutes, OR (CPC ≤2)
- 0.90 [0.87-0.93]
- Shockable rhythm, OR (ROSC)
- 2.52 [1.71-3.72]
- Shockable rhythm, OR (CPC ≤2)
- 10.68 [5.63-20.28]
- Defibrillations number, OR (ROSC)
- 1.15 [1.07-1.23]
- Defibrillations number, OR (CPC ≤2)
- 1.15 [1.04-1.26]
Original publication
Mechanical chest compression and extracorporeal life support for out-of-hospital cardiac arrest. A 30-month observational study in the metropolitan area of Milan, Italy. Resuscitation. Published 9 December 2022. doi:10.
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