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open access

Vol 30, No 4 (2023)
Original Article
Submitted: 2021-07-26
Accepted: 2021-08-02
Published online: 2021-09-30
View PDF Download PDF file View HTML Supp./Additional Files [1]
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Meta-analysis of chest compression-only versus conventional cardiopulmonary resuscitation by bystanders for adult with out-of-hospital cardiac arrest

Karol Bielski12, Jacek Smereka23, Jaroslaw Chmielewski4, Michal Pruc21, Francesco Chirico56, Aleksandra Gasecka78, Nataliia Litvinova9, Milosz J. Jaguszewski10, Grazyna Nowak-Starz11, Zubaid Rafique12, Frank W. Peacock12, Lukasz Szarpak13142
DOI: 10.5603/CJ.a2021.0115
·
Pubmed: 34622436
·
Cardiol J 2023;30(4):606-613.
Affiliations
  1. Institute of Outcomes Research, Polonia Academy, Czestochowa, Poland
  2. Polish Society of Disaster Medicine, Warsaw, Poland
  3. Department of Emergency Medical Service, Medical University of Wroclaw, Poland
  4. College of Rehabiliation, Warsaw, Poland
  5. Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
  6. Health Service Department, State Police, Ministry of Interior, Milan, Italy
  7. Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, the Netherlands
  8. 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland
  9. European Medical School, International European University, Kiev, Ukraine
  10. 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
  11. Collegium Medicum Institute of Health Sciences, Kochanowski University, Kielce, Poland
  12. Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, TX, United States
  13. Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
  14. Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland

open access

Vol 30, No 4 (2023)
Original articles — Clinical cardiology
Submitted: 2021-07-26
Accepted: 2021-08-02
Published online: 2021-09-30

Abstract

Background: According to the guidelines of cardiopulmonary resuscitation (CPR) conducted by bystanders,
two methods of CPR are feasible: standard CPR (sCPR) with mouth-to-mouth ventilations
and continuous chest compression-only CPR (CCC) without rescue breathing. The goal herein, was to
evaluate the effect of sCPR (30:2) and CCC on resuscitation outcomes in patients with out-of-hospital
cardiac arrest (OHCA) patients.

Methods: This study was a systematic review and meta-analysis. Using standardized criteria, Pub-
Med, Web of Science, Scopus, EMBASE and Cochrane Collaboration were searched for trials assessing
the effect of sCPR vs. CCC on resuscitation outcomes after adult OHCA. Random-effects model
meta-analysis was applied to calculate the mean deviation (MD), odds ratio (OR) and 95% confidence
interval (CI).

Results: Overall, 3 randomized controlled trials and 12 non-randomized trials met the inclusion
criteria. Survival to hospital discharge with sCPR was 10.2% compared to 9.3% in the CCC group
(OR = 1.04; 95% CI: 0.93–1.16; p = 0.46). Survival to hospital discharge with good neurological outcome
measured with the cerebral performance category (CPC 1 or 2) was 6.5% for sCPR vs. 5.8% for CCC
(OR = 1.00; 95% CI: 0.84–1.20; p = 0.98). Prehospital return of spontaneous circulation (ROSC) in
sCPR and CCC groups was 15.9% and 14.8%, respectively (OR = 1.13; 95% CI: 0.91–1.39; p = 0.26).
Survival to hospital admission with ROSC occurred in 29.5% of the sCPR group compared to 28.4%
in CCC group (OR = 1.20; 95% CI: 0.89–1.63; p = 0.24).

Conclusions: This systematic review and meta-analysis concluded that there were no significant differences
in the resuscitation outcomes between the use of standard cardiopulmonary resuscitation and
chest compression only.

Abstract

Background: According to the guidelines of cardiopulmonary resuscitation (CPR) conducted by bystanders,
two methods of CPR are feasible: standard CPR (sCPR) with mouth-to-mouth ventilations
and continuous chest compression-only CPR (CCC) without rescue breathing. The goal herein, was to
evaluate the effect of sCPR (30:2) and CCC on resuscitation outcomes in patients with out-of-hospital
cardiac arrest (OHCA) patients.

Methods: This study was a systematic review and meta-analysis. Using standardized criteria, Pub-
Med, Web of Science, Scopus, EMBASE and Cochrane Collaboration were searched for trials assessing
the effect of sCPR vs. CCC on resuscitation outcomes after adult OHCA. Random-effects model
meta-analysis was applied to calculate the mean deviation (MD), odds ratio (OR) and 95% confidence
interval (CI).

Results: Overall, 3 randomized controlled trials and 12 non-randomized trials met the inclusion
criteria. Survival to hospital discharge with sCPR was 10.2% compared to 9.3% in the CCC group
(OR = 1.04; 95% CI: 0.93–1.16; p = 0.46). Survival to hospital discharge with good neurological outcome
measured with the cerebral performance category (CPC 1 or 2) was 6.5% for sCPR vs. 5.8% for CCC
(OR = 1.00; 95% CI: 0.84–1.20; p = 0.98). Prehospital return of spontaneous circulation (ROSC) in
sCPR and CCC groups was 15.9% and 14.8%, respectively (OR = 1.13; 95% CI: 0.91–1.39; p = 0.26).
Survival to hospital admission with ROSC occurred in 29.5% of the sCPR group compared to 28.4%
in CCC group (OR = 1.20; 95% CI: 0.89–1.63; p = 0.24).

Conclusions: This systematic review and meta-analysis concluded that there were no significant differences
in the resuscitation outcomes between the use of standard cardiopulmonary resuscitation and
chest compression only.

Full Text:

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Keywords

out-of-hospital cardiac arrest, cardiopulmonary resuscitation, chest compression, continuous compressions

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About this article
Title

Meta-analysis of chest compression-only versus conventional cardiopulmonary resuscitation by bystanders for adult with out-of-hospital cardiac arrest

Journal

Cardiology Journal

Issue

Vol 30, No 4 (2023)

Article type

Original Article

Pages

606-613

Published online

2021-09-30

Page views

2386

Article views/downloads

1108

DOI

10.5603/CJ.a2021.0115

Pubmed

34622436

Bibliographic record

Cardiol J 2023;30(4):606-613.

Keywords

out-of-hospital cardiac arrest
cardiopulmonary resuscitation
chest compression
continuous compressions

Authors

Karol Bielski
Jacek Smereka
Jaroslaw Chmielewski
Michal Pruc
Francesco Chirico
Aleksandra Gasecka
Nataliia Litvinova
Milosz J. Jaguszewski
Grazyna Nowak-Starz
Zubaid Rafique
Frank W. Peacock
Lukasz Szarpak

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