Cardiopulmonary resuscitation quality and patient survival outcome in cardiac arrest: A systematic review and meta-analysis

Talikowska, Milena, Tohira, Hideo and Finn, Judith (2015) Cardiopulmonary resuscitation quality and patient survival outcome in cardiac arrest: A systematic review and meta-analysis. Resuscitation, 95 66-77. doi:10.1016/j.resuscitation.2015.07.036


Author Talikowska, Milena
Tohira, Hideo
Finn, Judith
Title Cardiopulmonary resuscitation quality and patient survival outcome in cardiac arrest: A systematic review and meta-analysis
Journal name Resuscitation   Check publisher's open access policy
ISSN 0300-9572
1873-1570
Publication date 2015-10
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.resuscitation.2015.07.036
Open Access Status Not Open Access
Volume 95
Start page 66
End page 77
Total pages 12
Place of publication Shannon, Clare Ireland
Publisher Elsevier
Collection year 2016
Language eng
Formatted abstract
Aim
To conduct a systematic review and meta-analysis to determine whether cardiopulmonary resuscitation (CPR) quality, as indicated by parameters such as chest compression depth, compression rate and compression fraction, is associated with patient survival from cardiac arrest.

Methods
Five databases were searched (MEDLINE, Embase, CINAHL, Scopus and Cochrane) as well as the grey literature (MedNar). To satisfy inclusion criteria, studies had to document human cases of in- or out-of hospital cardiac arrest where CPR quality had been recorded using an automated device and linked to patient survival. Where indicated (I2 < 75%), meta-analysis was undertaken to examine the relationship between individual CPR quality parameters and either survival to hospital discharge (STHD) or return of spontaneous circulation (ROSC).

Results
Database searching yielded 8,842 unique citations, resulting in the inclusion of 22 relevant articles. Thirteen were included in the meta-analysis. Chest compression depth was significantly associated with STHD (mean difference (MD) between survivors and non-survivors 2.59 mm, 95% CI: 0.71, 4.47); and with ROSC (MD 0.99 mm, 95% CI: 0.04, 1.93). Within the range of approximately 100–120 compressions per minute (cpm), compression rate was significantly associated with STHD; survivors demonstrated a lower mean compression rate than non-survivors (MD −1.17 cpm, 95% CI: −2.21, −0.14). Compression fraction could not be examined by meta-analysis due to high heterogeneity, however a higher fraction appeared to be associated with survival in cases with a shockable initial rhythm.

Conclusions
Chest compression depth and rate were associated with survival outcomes. More studies with consistent reporting of data are required for other quality parameters.
Keyword Cardiac arrest
Cardiopulmonary resuscitation
Quality
Survival
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Nursing, Midwifery and Social Work Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 5 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 5 times in Scopus Article | Citations
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Created: Mon, 19 Oct 2015, 13:06:35 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work