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Volume 11
Issue 5
10.3390/jcm11051448
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Review
Peer-Review Record

Comparison between Prehospital Mechanical Cardiopulmonary Resuscitation (CPR) Devices and Manual CPR for Out-of-Hospital Cardiac Arrest: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis

J. Clin. Med. 2022, 11(5), 1448; https://doi.org/10.3390/jcm11051448
by Cheng-Ying Chiang 1,†, Ket-Cheong Lim 1,†, Pei Chun Lai 2, Tou-Yuan Tsai 3,4, Yen Ta Huang 5,* and Ming-Jen Tsai 1,*
Reviewer 1: Anonymous
Reviewer 2: Anonymous
J. Clin. Med. 2022, 11(5), 1448; https://doi.org/10.3390/jcm11051448
Submission received: 1 February 2022 / Revised: 3 March 2022 / Accepted: 3 March 2022 / Published: 7 March 2022
(This article belongs to the Special Issue Cardiopulmonary Resuscitation: Clinical Updates and Perspectives)

Round 1

Reviewer 1 Report

In their manuscript, Chiang et al. conducted a SRMA of the published literature on the use of mechanical CPR devices compared to manual CPR for adult OHCA. The final analysis included 7 RCT's and 15 non-randomized trials. Compared to manual CPR, pre-hospital use of mechanical CPR showed a positive effect in achieving ROSC (OR=1.32; 95% CI: 1.11–1.58) and survival to admission (OR=1.23; 95% CI:1.04–1.47). No difference was found in survival to discharge and discharge with favorable neurological status, with inconclusive results in Trial sequential analysis. They used the GRADE methodology to assess the certainty of evidence. The GRADE assessment demonstrated an overall very low certainty of evidence in the four survival outcomes. 

The manuscript is clear and presented in a well-structured manner, and the conclusions are consistent with the evidence and arguments presented. 

This SRMA focused on OHCA and included recent publications that were not included in past systematic reviews, as well as trial sequential analysis and GRADE assessments.

The authors acknowledge the main limitations of this SRMA, including the synthesis of both RCT's and non-randomized trials and the inability to assess mechanical CPR complications and post-arrest care.  

I found this manuscript to be clinically relevant and interesting to read. 

Author Response

Thank you for your kind words and comments.

Reviewer 2 Report

The paper presents Comparison between prehospital mechanical cardiopulmonary resuscitation (CPR) devices and manual CPR for out-of-hospital cardiac arrest: a systematic review, meta-analysis, and trial sequential analysis. Overall, the scientific objective is important, especially during ingoin coronavirus pandemic. The article is well written and comprehensive.
There are no ethical concerns about this study. The research design is appropriate and the methods clearly explained. The interpretation of the results is clearly presented and adequately supported by the evidence adduced. The references are up-to-date and the most important studies have been cited.

Author Response

Thank you for your kind words and comments.

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