Use of Mechanical Chest Compression for Resuscitation in Out-Of-Hospital Cardiac Arrest—Device Matters: A Propensity-Score-Based Match Analysis

Primi, Roberto; Bendotti, Sara; Currao, Alessia; Sechi, Giuseppe Maria; Marconi, Gianluca; Pamploni, Greta; Panni, Gianluca; Sgotti, Davide; Zorzi, Ettore; Cazzaniga, Marco; Piccolo, Umberto; Bussi, Daniele; Ruggeri, Simone; Facchin, Fabio; Soffiato, Edoardo; Ronchi, Vincenza; Contri, Enrico; Centineo, Paola; Reali, Francesca; Sfolcini, Luigi; Gentile, Francesca Romana; Baldi, Enrico; Compagnoni, Sara; Quilico, Federico; Vicini Scajola, Luca; Lopiano, Clara; Fasolino, Alessandro; Savastano, Simone; all the Lombardia CARe Researchers,

doi:10.3390/jcm12134429

Open AccessFeature PaperArticle

Use of Mechanical Chest Compression for Resuscitation in Out-Of-Hospital Cardiac Arrest—Device Matters: A Propensity-Score-Based Match Analysis

by

Roberto Primi

^1,2

,

Sara Bendotti

¹

,

Alessia Currao

¹

,

Giuseppe Maria Sechi

³,

Gianluca Marconi

³,

Greta Pamploni

⁴,

Gianluca Panni

⁵,

Davide Sgotti

⁵,

Ettore Zorzi

⁶,

Marco Cazzaniga

⁶,

Umberto Piccolo

⁶,

Daniele Bussi

⁷,

Simone Ruggeri

⁷,

Fabio Facchin

⁸

,

Edoardo Soffiato

⁸

,

Vincenza Ronchi

⁹,

Enrico Contri

⁴,

Paola Centineo

¹⁰,

Francesca Reali

¹¹,

Luigi Sfolcini

¹²,

Francesca Romana Gentile

^1,12

,

Enrico Baldi

¹

,

Sara Compagnoni

^1,12

,

Federico Quilico

^1,12,

Luca Vicini Scajola

^1,12,

Clara Lopiano

^1,12,

Alessandro Fasolino

^1,12

,

Simone Savastano

^1,*

and

all the Lombardia CARe Researchers

^† Show full author list Hide full author list

¹

Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy

²

Department of Public Health, Experimental and Forensic Medicine, Section of Biostatistics and Clinical Epidemiology, University of Pavia, 27100 Pavia, Italy

³

Agenzia Regionale dell’Emergenza Urgenza (AREU) Lombardia, 20124 Milan, Italy

⁴

AAT Pavia—Agenzia Regionale Emergenza Urgenza (AREU) c/o Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy

⁵

AAT Brescia—Agenzia Regionale Emergenza Urgenza (AREU) c/o ASST Degli Spedali Civili di Brescia, 25100 Brescia, Italy

⁶

AAT Como—Agenzia Regionale Emergenza Urgenza (AREU) c/o ASST Lariana (CO), 22079 Como, Italy

⁷

AAT Cremona—Agenzia Regionale Emergenza Urgenza (AREU) c/o ASST di Cremona, 26100 Cremona, Italy

⁸

AAT Mantova—Agenzia Regionale Emergenza Urgenza (AREU) c/o ASST di Mantova, 46100 Mantova, Italy

⁹

AAT Pavia—Agenzia Regionale Emergenza Urgenza (AREU) c/o ASST Pavia, 27100 Pavia, Italy

¹⁰

AAT Varese—Agenzia Regionale Emergenza Urgenza (AREU) c/o ASST dei Sette Laghi, 21100 Varese, Italy

¹¹

AAT Lodi—Agenzia Regionale Emergenza Urgenza (AREU) c/o ASST di Lodi, 26900 Lodi, Italy

¹²

Department of Molecular Medicine, Section of Cardiology, University of Pavia, 27100 Pavia, Italy

Show full affiliation list

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^*

Author to whom correspondence should be addressed.

^†

Lombardia CARe researchers are listed in acknowledgments.

J. Clin. Med. 2023, 12(13), 4429; https://doi.org/10.3390/jcm12134429

Submission received: 6 June 2023 / Revised: 27 June 2023 / Accepted: 27 June 2023 / Published: 30 June 2023

(This article belongs to the Special Issue Clinical Advances in Ventricular Arrhythmia and Cardiac Arrest)

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Abstract

Background. Devices for mechanical cardiopulmonary resuscitation (CPR) are recommended when high quality CPR cannot be provided. Different devices are available, but the literature is poor in direct comparison studies. Our aim was to assess whether the type of mechanical chest compressor could affect the probability of return of spontaneous circulation (ROSC) and 30-day survival in Out-of-Hospital Cardiac Arrest (OHCA) patients as compared to manual standard CPR. Methods. We considered all OHCAs that occurred from 1 January 2015 to 31 December 2022 in seven provinces of the Lombardy region equipped with three different types of mechanical compressor: Autopulse^®(ZOLL Medical, MA), LUCAS^® (Stryker, MI), and Easy Pulse^® (Schiller, Switzerland). Results. Two groups, 2146 patients each (manual and mechanical CPR), were identified by propensity-score-based random matching. The rates of ROSC (15% vs. 23%, p < 0.001) and 30-day survival (6% vs. 14%, p < 0.001) were lower in the mechanical CPR group. After correction for confounders, Autopulse^® [OR 2.1, 95%CI (1.6–2.8), p < 0.001] and LUCAS^® [OR 2.5, 95%CI (1.7–3.6), p < 0.001] significantly increased the probability of ROSC, and Autopulse^® significantly increased the probability of 30-day survival compared to manual CPR [HR 0.9, 95%CI (0.8–0.9), p = 0.005]. Conclusion. Mechanical chest compressors could increase the rate of ROSC, especially in case of prolonged resuscitation. The devices were dissimilar, and their different performances could significantly influence patient outcomes. The load-distributing-band device was the only mechanical chest able to favorably affect 30-day survival.

Keywords: cardiopulmonary resuscitation; cardiac arrest; resuscitation; survival; mechanical chest compression

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MDPI and ACS Style

Primi, R.; Bendotti, S.; Currao, A.; Sechi, G.M.; Marconi, G.; Pamploni, G.; Panni, G.; Sgotti, D.; Zorzi, E.; Cazzaniga, M.; et al. Use of Mechanical Chest Compression for Resuscitation in Out-Of-Hospital Cardiac Arrest—Device Matters: A Propensity-Score-Based Match Analysis. J. Clin. Med. 2023, 12, 4429. https://doi.org/10.3390/jcm12134429

AMA Style

Primi R, Bendotti S, Currao A, Sechi GM, Marconi G, Pamploni G, Panni G, Sgotti D, Zorzi E, Cazzaniga M, et al. Use of Mechanical Chest Compression for Resuscitation in Out-Of-Hospital Cardiac Arrest—Device Matters: A Propensity-Score-Based Match Analysis. Journal of Clinical Medicine. 2023; 12(13):4429. https://doi.org/10.3390/jcm12134429

Chicago/Turabian Style

Primi, Roberto, Sara Bendotti, Alessia Currao, Giuseppe Maria Sechi, Gianluca Marconi, Greta Pamploni, Gianluca Panni, Davide Sgotti, Ettore Zorzi, Marco Cazzaniga, and et al. 2023. "Use of Mechanical Chest Compression for Resuscitation in Out-Of-Hospital Cardiac Arrest—Device Matters: A Propensity-Score-Based Match Analysis" Journal of Clinical Medicine 12, no. 13: 4429. https://doi.org/10.3390/jcm12134429

APA Style

Primi, R., Bendotti, S., Currao, A., Sechi, G. M., Marconi, G., Pamploni, G., Panni, G., Sgotti, D., Zorzi, E., Cazzaniga, M., Piccolo, U., Bussi, D., Ruggeri, S., Facchin, F., Soffiato, E., Ronchi, V., Contri, E., Centineo, P., Reali, F., ... all the Lombardia CARe Researchers. (2023). Use of Mechanical Chest Compression for Resuscitation in Out-Of-Hospital Cardiac Arrest—Device Matters: A Propensity-Score-Based Match Analysis. Journal of Clinical Medicine, 12(13), 4429. https://doi.org/10.3390/jcm12134429

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Use of Mechanical Chest Compression for Resuscitation in Out-Of-Hospital Cardiac Arrest—Device Matters: A Propensity-Score-Based Match Analysis

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