Current opinion in critical care
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Curr Opin Crit Care · Jun 2010
ReviewMechanical chest-compression devices: current and future roles.
It is recognized that the quality of cardiopulmonary resuscitation (CPR) is an important predictor of outcome from cardiac arrest yet studies consistently demonstrate that the quality of CPR performed in real life is frequently sub-optimal. Mechanical chest-compression devices provide an alternative to manual CPR. This review will consider the evidence and current indications for the use of these devices. ⋯ There is insufficient evidence to recommend the routine use of mechanical chest-compression devices. There may be specific circumstances when CPR is difficult or impossible where mechanical devices may play an important role in maintaining circulation. There is an urgent need for definitive clinical and cost effectiveness trials to confirm or refute the place of mechanical chest-compression devices during resuscitation.
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Out-of-hospital cardiac arrest (OOHCA) is a common public health problem. Regional systems of care have improved provider experience and patient outcomes for those with ST-elevation myocardial infarction and life-threatening traumatic injury. We review evidence of the effectiveness of regional cardiac resuscitation systems and describe preliminary recommended elements of such systems. ⋯ Many more people could survive OOHCA if regional systems of cardiac resuscitation were established. The time has come to implement such systems whenever feasible.