{"title":"心脏骤停时机械与人工心肺复苏术的比较","authors":"Yang Zhao, Da Chen, Qian Wang","doi":"10.1186/s13054-024-05088-7","DOIUrl":null,"url":null,"abstract":"<p>To the editor</p><p>We read with great interest the article by El-Menyar et al., titled “Mechanical versus manual cardiopulmonary resuscitation (CPR): an umbrella review of contemporary systematic reviews and more”, recently published in <i>Critical Care</i> [1]. The findings from the umbrella review and the new systematic review in this study suggest that mechanical CPR is not superior to manual CPR in achieving return of spontaneous circulation (ROSC).</p><p>Although this article offers valuable insights, several issues warrant further discussion and clarification. In Fig. 2’s Forest plot for ROSC from El-Menyar et al.’s article, we observed some issues with the study selection. The umbrella meta-analysis included duplicated studies [2, 3] and studies with no ROSC-related data upon our detailed review [4, 5]. Additionally, the inclusion of just the abstracts from three studies [6, 7, 8] could potentially limit the robustness of the findings. Moreover, when replicating the authors’ search strategy, we identified a missing randomized controlled trial (RCT) comparing mechanical and manual CPR in in-hospital cardiac arrest (IHCA) settings [9].</p><p>We consolidated studies from the umbrella review and the new systematic review, excluding improperly included studies and adding the newly identified RCT. Using Stata Version 16.0 (StataCorp, College Station, TX), we conducted subgroup analyses for out-of-hospital cardiac arrest (OHCA) and IHCA patients across RCTs and non-RCTs. For OHCA patients, mechanical CPR did not improve ROSC rates in either study type. However, the IHCA outcomes varied by study type: RCTs showed a higher probability of ROSC with mechanical CPR, whereas non-RCTs indicated a reduced likelihood of achieving ROSC (Figs. 1 and 2)</p><figure><figcaption><b data-test=\"figure-caption-text\">Fig. 1</b></figcaption><picture><source srcset=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-024-05088-7/MediaObjects/13054_2024_5088_Fig1_HTML.png?as=webp\" type=\"image/webp\"/><img alt=\"figure 1\" aria-describedby=\"Fig1\" height=\"631\" loading=\"lazy\" src=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-024-05088-7/MediaObjects/13054_2024_5088_Fig1_HTML.png\" width=\"685\"/></picture><p>Forest plot of ROSC in mechanical CPR versus manual CPR in RCTs. ROSC, return of spontaneous circulation; CPR, cardiopulmonary resuscitation; OHCA, out-of-hospital cardiac arrest; IHCA, in-hospital cardiac arrest; RCT, randomized controlled trial; CI, confidence interval</p><span>Full size image</span><svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-chevron-right-small\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></figure><figure><figcaption><b data-test=\"figure-caption-text\">Fig. 2</b></figcaption><picture><source srcset=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-024-05088-7/MediaObjects/13054_2024_5088_Fig2_HTML.png?as=webp\" type=\"image/webp\"/><img alt=\"figure 2\" aria-describedby=\"Fig2\" height=\"898\" loading=\"lazy\" src=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-024-05088-7/MediaObjects/13054_2024_5088_Fig2_HTML.png\" width=\"685\"/></picture><p>Forest plot of ROSC in mechanical CPR versus manual CPR in non-RCTs. ROSC, return of spontaneous circulation; CPR, cardiopulmonary resuscitation; OHCA, out-of-hospital cardiac arrest; IHCA, in-hospital cardiac arrest; RCT, randomized controlled trial; CI, confidence interval</p><span>Full size image</span><svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-chevron-right-small\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></figure><p>.</p><p>While our analysis supports the finding that mechanical CPR does not improve ROSC rates in OHCA settings, as highlighted in the meta-analysis by El-Menyar et al., the variable results for IHCA indicate a need for further investigation. In particular, the discrepancies between RCTs and non-RCTs in IHCA settings imply underlying differences that could influence CPR outcomes. These differences may include variations in patient characteristics, response times, and hospital settings. Additionally, limitations in study design, such as selection biases commonly seen in observational studies, could also be contributing factors. Further large-scale RCTs are required to determine the effectiveness of mechanical versus manual CPR in improving patient outcomes during cardiac arrest.\n</p><p>No datasets were generated or analysed during the current study.</p><ol data-track-component=\"outbound reference\" data-track-context=\"references section\"><li data-counter=\"1.\"><p>El-Menyar A, Naduvilekandy M, Rizoli S, Di Somma S, Cander B, Galwankar S, Lateef F, Abdul Rahman MA, Nanayakkara P, Al-Thani H. Mechanical versus manual cardiopulmonary resuscitation (CPR): an umbrella review of contemporary systematic reviews and more. Crit Care. 2024;28(1):259.</p><p>Article PubMed PubMed Central Google Scholar </p></li><li data-counter=\"2.\"><p>Hock Ong ME, Fook-Chong S, Annathurai A, Ang SH, Tiah L, Yong KL, Koh ZX, Yap S, Sultana P. 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An automated CPR device compared with standard chest compressions for out-of-hospital resuscitation. BMC Emerg Med. 2012;12:8.</p><p>Article PubMed PubMed Central Google Scholar </p></li><li data-counter=\"6.\"><p>Lairet JR, Lee M. A comparison of standard manual cardiopulmonary resuscitation versus the autopulse mechanical cardiopulmonary resuscitation device. Ann Emerg Med. 2005;46(3).</p></li><li data-counter=\"7.\"><p>Paradis NAKD, Ghilarducci D, Palazzolo J. California AutoPulse Registry Steering Committee. The California AutoPulse Quality Assurance Registry. Circulation. 2009;120:S1457.</p><p>Google Scholar </p></li><li data-counter=\"8.\"><p>Morozov SNAS, Fedorov AY. Improved prognosis after implementation of chest compression device in out-of-hospital cardiac arrest. Eur Heart J. 2012;3:S702.</p><p>Google Scholar </p></li><li data-counter=\"9.\"><p>Couper K, Quinn T, Booth K, Lall R, Devrell A, Orriss B, Regan S, Yeung J, Perkins GD. Mechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm: a multi-centre feasibility randomised controlled trial (COMPRESS-RCT). Resuscitation. 2021;158:228–35.</p><p>Article PubMed PubMed Central Google Scholar </p></li></ol><p>Download references<svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></p><p>Not applicable.</p><p>None.</p><h3>Authors and Affiliations</h3><ol><li><p>Department of Critical Care Medicine, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, 110000, China</p><p>Yang Zhao</p></li><li><p>Department of Emergency, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan East Road, Shenyang, 110000, China</p><p>Da Chen & Qian Wang</p></li></ol><span>Authors</span><ol><li><span>Yang Zhao</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Da Chen</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Qian Wang</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Contributions</h3><p>YZ and QW were responsible for literature research, data extraction, and figure production. DC was responsible for supervision. All the authors participated in the draft writing, review, and editing.</p><h3>Corresponding authors</h3><p>Correspondence to Da Chen or Qian Wang.</p><h3>Consent for publication</h3>\n<p>Not applicable.</p>\n<h3>Competing interests</h3>\n<p>The authors declare no competing interests.</p>\n<h3>Ethical approval and consent to participate</h3>\n<p>Not applicable.</p><h3>Publisher’s note</h3><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p><p><b>Open Access</b> This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.</p>\n<p>Reprints and permissions</p><img alt=\"Check for updates. 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0-.92-.08-1.33-.25-.41-.16-.77-.4-1.08-.7-.3-.31-.54-.69-.72-1.13-.17-.44-.26-.95-.26-1.52zm4.61-.62c0-.55-.11-.98-.34-1.28-.23-.31-.58-.47-1.06-.47-.41 0-.77.15-1.08.45-.31.29-.5.73-.57 1.3zm3.01 2.23c.31.24.61.43.92.57.3.13.63.2.98.2.38 0 .65-.08.83-.23s.27-.35.27-.6c0-.14-.05-.26-.13-.37-.08-.1-.2-.2-.34-.28-.14-.09-.29-.16-.47-.23l-.53-.22c-.23-.09-.46-.18-.69-.3-.23-.11-.44-.24-.62-.4s-.33-.35-.45-.55c-.12-.21-.18-.46-.18-.75 0-.61.23-1.1.68-1.49.44-.38 1.06-.57 1.83-.57.48 0 .91.08 1.29.25s.71.36.99.57l-.74.98c-.24-.17-.49-.32-.73-.42-.25-.11-.51-.16-.78-.16-.35 0-.6.07-.76.21-.17.15-.25.33-.25.54 0 .14.04.26.12.36s.18.18.31.26c.14.07.29.14.46.21l.54.19c.23.09.47.18.7.29s.44.24.64.4c.19.16.34.35.46.58.11.23.17.5.17.82 0 .3-.06.58-.17.83-.12.26-.29.48-.51.68-.23.19-.51.34-.84.45-.34.11-.72.17-1.15.17-.48 0-.95-.09-1.41-.27-.46-.19-.86-.41-1.2-.68z" fill="#535353"/></g></svg>\" width=\"57\"/><h3>Cite this article</h3><p>Zhao, Y., Chen, D. & Wang, Q. Comparison of mechanical versus manual cardiopulmonary resuscitation in cardiac arrest. <i>Crit Care</i> <b>28</b>, 319 (2024). https://doi.org/10.1186/s13054-024-05088-7</p><p>Download citation<svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></p><ul data-test=\"publication-history\"><li><p>Received<span>: </span><span><time datetime=\"2024-09-01\">01 September 2024</time></span></p></li><li><p>Accepted<span>: </span><span><time datetime=\"2024-09-06\">06 September 2024</time></span></p></li><li><p>Published<span>: </span><span><time datetime=\"2024-09-27\">27 September 2024</time></span></p></li><li><p>DOI</abbr><span>: </span><span>https://doi.org/10.1186/s13054-024-05088-7</span></p></li></ul><h3>Share this article</h3><p>Anyone you share the following link with will be able to read this content:</p><button data-track=\"click\" data-track-action=\"get shareable link\" data-track-external=\"\" data-track-label=\"button\" type=\"button\">Get shareable link</button><p>Sorry, a shareable link is not currently available for this article.</p><p data-track=\"click\" data-track-action=\"select share url\" data-track-label=\"button\"></p><button data-track=\"click\" data-track-action=\"copy share url\" data-track-external=\"\" data-track-label=\"button\" type=\"button\">Copy to clipboard</button><p> Provided by the Springer Nature SharedIt content-sharing initiative </p>","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":null,"pages":null},"PeriodicalIF":8.8000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of mechanical versus manual cardiopulmonary resuscitation in cardiac arrest\",\"authors\":\"Yang Zhao, Da Chen, Qian Wang\",\"doi\":\"10.1186/s13054-024-05088-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>To the editor</p><p>We read with great interest the article by El-Menyar et al., titled “Mechanical versus manual cardiopulmonary resuscitation (CPR): an umbrella review of contemporary systematic reviews and more”, recently published in <i>Critical Care</i> [1]. The findings from the umbrella review and the new systematic review in this study suggest that mechanical CPR is not superior to manual CPR in achieving return of spontaneous circulation (ROSC).</p><p>Although this article offers valuable insights, several issues warrant further discussion and clarification. In Fig. 2’s Forest plot for ROSC from El-Menyar et al.’s article, we observed some issues with the study selection. The umbrella meta-analysis included duplicated studies [2, 3] and studies with no ROSC-related data upon our detailed review [4, 5]. Additionally, the inclusion of just the abstracts from three studies [6, 7, 8] could potentially limit the robustness of the findings. Moreover, when replicating the authors’ search strategy, we identified a missing randomized controlled trial (RCT) comparing mechanical and manual CPR in in-hospital cardiac arrest (IHCA) settings [9].</p><p>We consolidated studies from the umbrella review and the new systematic review, excluding improperly included studies and adding the newly identified RCT. Using Stata Version 16.0 (StataCorp, College Station, TX), we conducted subgroup analyses for out-of-hospital cardiac arrest (OHCA) and IHCA patients across RCTs and non-RCTs. For OHCA patients, mechanical CPR did not improve ROSC rates in either study type. However, the IHCA outcomes varied by study type: RCTs showed a higher probability of ROSC with mechanical CPR, whereas non-RCTs indicated a reduced likelihood of achieving ROSC (Figs. 1 and 2)</p><figure><figcaption><b data-test=\\\"figure-caption-text\\\">Fig. 1</b></figcaption><picture><source srcset=\\\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-024-05088-7/MediaObjects/13054_2024_5088_Fig1_HTML.png?as=webp\\\" type=\\\"image/webp\\\"/><img alt=\\\"figure 1\\\" aria-describedby=\\\"Fig1\\\" height=\\\"631\\\" loading=\\\"lazy\\\" src=\\\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-024-05088-7/MediaObjects/13054_2024_5088_Fig1_HTML.png\\\" width=\\\"685\\\"/></picture><p>Forest plot of ROSC in mechanical CPR versus manual CPR in RCTs. ROSC, return of spontaneous circulation; CPR, cardiopulmonary resuscitation; OHCA, out-of-hospital cardiac arrest; IHCA, in-hospital cardiac arrest; RCT, randomized controlled trial; CI, confidence interval</p><span>Full size image</span><svg aria-hidden=\\\"true\\\" focusable=\\\"false\\\" height=\\\"16\\\" role=\\\"img\\\" width=\\\"16\\\"><use xlink:href=\\\"#icon-eds-i-chevron-right-small\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"></use></svg></figure><figure><figcaption><b data-test=\\\"figure-caption-text\\\">Fig. 2</b></figcaption><picture><source srcset=\\\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-024-05088-7/MediaObjects/13054_2024_5088_Fig2_HTML.png?as=webp\\\" type=\\\"image/webp\\\"/><img alt=\\\"figure 2\\\" aria-describedby=\\\"Fig2\\\" height=\\\"898\\\" loading=\\\"lazy\\\" src=\\\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-024-05088-7/MediaObjects/13054_2024_5088_Fig2_HTML.png\\\" width=\\\"685\\\"/></picture><p>Forest plot of ROSC in mechanical CPR versus manual CPR in non-RCTs. ROSC, return of spontaneous circulation; CPR, cardiopulmonary resuscitation; OHCA, out-of-hospital cardiac arrest; IHCA, in-hospital cardiac arrest; RCT, randomized controlled trial; CI, confidence interval</p><span>Full size image</span><svg aria-hidden=\\\"true\\\" focusable=\\\"false\\\" height=\\\"16\\\" role=\\\"img\\\" width=\\\"16\\\"><use xlink:href=\\\"#icon-eds-i-chevron-right-small\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"></use></svg></figure><p>.</p><p>While our analysis supports the finding that mechanical CPR does not improve ROSC rates in OHCA settings, as highlighted in the meta-analysis by El-Menyar et al., the variable results for IHCA indicate a need for further investigation. In particular, the discrepancies between RCTs and non-RCTs in IHCA settings imply underlying differences that could influence CPR outcomes. These differences may include variations in patient characteristics, response times, and hospital settings. Additionally, limitations in study design, such as selection biases commonly seen in observational studies, could also be contributing factors. Further large-scale RCTs are required to determine the effectiveness of mechanical versus manual CPR in improving patient outcomes during cardiac arrest.\\n</p><p>No datasets were generated or analysed during the current study.</p><ol data-track-component=\\\"outbound reference\\\" data-track-context=\\\"references section\\\"><li data-counter=\\\"1.\\\"><p>El-Menyar A, Naduvilekandy M, Rizoli S, Di Somma S, Cander B, Galwankar S, Lateef F, Abdul Rahman MA, Nanayakkara P, Al-Thani H. Mechanical versus manual cardiopulmonary resuscitation (CPR): an umbrella review of contemporary systematic reviews and more. Crit Care. 2024;28(1):259.</p><p>Article PubMed PubMed Central Google Scholar </p></li><li data-counter=\\\"2.\\\"><p>Hock Ong ME, Fook-Chong S, Annathurai A, Ang SH, Tiah L, Yong KL, Koh ZX, Yap S, Sultana P. 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Resuscitation. 2021;158:228–35.</p><p>Article PubMed PubMed Central Google Scholar </p></li></ol><p>Download references<svg aria-hidden=\\\"true\\\" focusable=\\\"false\\\" height=\\\"16\\\" role=\\\"img\\\" width=\\\"16\\\"><use xlink:href=\\\"#icon-eds-i-download-medium\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"></use></svg></p><p>Not applicable.</p><p>None.</p><h3>Authors and Affiliations</h3><ol><li><p>Department of Critical Care Medicine, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, 110000, China</p><p>Yang Zhao</p></li><li><p>Department of Emergency, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan East Road, Shenyang, 110000, China</p><p>Da Chen & Qian Wang</p></li></ol><span>Authors</span><ol><li><span>Yang Zhao</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Da Chen</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Qian Wang</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Contributions</h3><p>YZ and QW were responsible for literature research, data extraction, and figure production. DC was responsible for supervision. All the authors participated in the draft writing, review, and editing.</p><h3>Corresponding authors</h3><p>Correspondence to Da Chen or Qian Wang.</p><h3>Consent for publication</h3>\\n<p>Not applicable.</p>\\n<h3>Competing interests</h3>\\n<p>The authors declare no competing interests.</p>\\n<h3>Ethical approval and consent to participate</h3>\\n<p>Not applicable.</p><h3>Publisher’s note</h3><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p><p><b>Open Access</b> This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.</p>\\n<p>Reprints and permissions</p><img alt=\\\"Check for updates. 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Comparison of mechanical versus manual cardiopulmonary resuscitation in cardiac arrest. <i>Crit Care</i> <b>28</b>, 319 (2024). https://doi.org/10.1186/s13054-024-05088-7</p><p>Download citation<svg aria-hidden=\\\"true\\\" focusable=\\\"false\\\" height=\\\"16\\\" role=\\\"img\\\" width=\\\"16\\\"><use xlink:href=\\\"#icon-eds-i-download-medium\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"></use></svg></p><ul data-test=\\\"publication-history\\\"><li><p>Received<span>: </span><span><time datetime=\\\"2024-09-01\\\">01 September 2024</time></span></p></li><li><p>Accepted<span>: </span><span><time datetime=\\\"2024-09-06\\\">06 September 2024</time></span></p></li><li><p>Published<span>: </span><span><time datetime=\\\"2024-09-27\\\">27 September 2024</time></span></p></li><li><p>DOI</abbr><span>: </span><span>https://doi.org/10.1186/s13054-024-05088-7</span></p></li></ul><h3>Share this article</h3><p>Anyone you share the following link with will be able to read this content:</p><button data-track=\\\"click\\\" data-track-action=\\\"get shareable link\\\" data-track-external=\\\"\\\" data-track-label=\\\"button\\\" type=\\\"button\\\">Get shareable link</button><p>Sorry, a shareable link is not currently available for this article.</p><p data-track=\\\"click\\\" data-track-action=\\\"select share url\\\" data-track-label=\\\"button\\\"></p><button data-track=\\\"click\\\" data-track-action=\\\"copy share url\\\" data-track-external=\\\"\\\" data-track-label=\\\"button\\\" type=\\\"button\\\">Copy to clipboard</button><p> Provided by the Springer Nature SharedIt content-sharing initiative </p>\",\"PeriodicalId\":10811,\"journal\":{\"name\":\"Critical Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":8.8000,\"publicationDate\":\"2024-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Critical Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13054-024-05088-7\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13054-024-05088-7","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
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摘要
致编辑我们饶有兴趣地阅读了 El-Menyar 等人最近发表在《重症监护》(Critical Care)[1]上的题为 "机械心肺复苏(CPR)与徒手心肺复苏(CPR):当代系统综述及其他"(Mechanical versus manual cardiopulmonary resuscitation (CPR): an umbrella review of contemporary systematic reviews and more)的文章。虽然这篇文章提供了有价值的见解,但有几个问题值得进一步讨论和澄清。在图 2 El-Menyar 等人文章中的 ROSC 森林图中,我们发现研究选择存在一些问题。总括荟萃分析包括了重复的研究[2, 3],以及经我们详细审查后没有 ROSC 相关数据的研究[4, 5]。此外,仅纳入三项研究[6、7、8]的摘要可能会限制研究结果的稳健性。此外,在复制作者的搜索策略时,我们发现了一项缺失的随机对照试验(RCT),该试验比较了院内心脏骤停(IHCA)情况下机械心肺复苏术和人工心肺复苏术[9]。我们使用 Stata 16.0 版(StataCorp,College Station,Texas)对院外心脏骤停(OHCA)和 IHCA 患者的 RCT 和非 RCT 进行了分组分析。对于院外心脏骤停患者,在两种研究类型中,机械心肺复苏都没有提高ROSC率。但是,IHCA 的结果因研究类型而异:研究表明,机械心肺复苏的 ROSC 概率较高,而非研究表明,达到 ROSC 的概率较低(图 1 和图 2)。ROSC,自主循环恢复;CPR,心肺复苏;OHCA,院外心脏骤停;IHCA,院内心脏骤停;RCT,随机对照试验;CI,置信区间全尺寸图片图 2非 RCT 中机械心肺复苏与徒手心肺复苏的 ROSC 树状图。ROSC:自发性循环恢复;CPR:心肺复苏;OHCA:院外心脏骤停;IHCA:院内心脏骤停;RCT:随机对照试验;CI:置信区间全尺寸图片。虽然我们的分析支持 El-Menyar 等人的荟萃分析中强调的机械心肺复苏并不能提高 OHCA 情况下的 ROSC 率这一结论,但 IHCA 的不同结果表明需要进一步研究。特别是,在 IHCA 情况下,RCT 与非 RCT 之间的差异意味着可能影响 CPR 结果的潜在差异。这些差异可能包括患者特征、响应时间和医院环境的不同。此外,研究设计中的局限性(如观察性研究中常见的选择偏差)也可能是影响因素之一。要确定机械心肺复苏术与徒手心肺复苏术在改善心脏骤停患者预后方面的有效性,还需要进一步开展大规模的 RCT 研究。机械心肺复苏(CPR)与徒手心肺复苏(CPR):当代系统性综述及更多综述。Crit Care.2024;28(1):259.Article PubMed PubMed Central Google Scholar Hock Ong ME、Fook-Chong S、Annathurai A、Ang SH、Tiah L、Yong KL、Koh ZX、Yap S、Sultana P. 在急诊科就诊的心脏骤停患者中使用自动负荷分配带胸外按压装置提高了神经功能完好者的存活率。Crit Care.2012;16(4):R144.Article PubMed PubMed Central Google Scholar Casner M, Andersen D, Isaacs SM.新型心肺复苏辅助装置对院外心脏骤停患者自主循环恢复率的影响》。Prehosp Emerg Care.2005; 9(1):61-7.Article PubMed Google Scholar Axelsson C, Herrera MJ, Fredriksson M, Lindqvist J, Herlitz J. 在急救医疗服务系统中对院外心脏骤停患者实施机械胸外按压。Am J Emerg Med.2013;31(8):1196-200.Article PubMed Google Scholar Jennings PA, Harriss L, Bernard S, Bray J, Walker T, Spelman T, Smith K, Cameron P. An automated CPR device compared with standard chest compressions for out-of-hospital resuscitation.BMC Emerg Med.2012; 12:8.Article PubMed PubMed Central Google Scholar Lairet JR, Lee M. A comparison of standard manual cardiopulmonary resuscitation versus the autopulse mechanical cardiopulmonary resuscitation device.Ann Emerg Med.2005; 46(3).Paradis NAKD, Ghilarducci D, Palazzolo J. 加利福尼亚自动脉冲注册指导委员会。加利福尼亚自动脉冲质量保证注册。循环。2009;120:S1457.Google Scholar Morozov SNAS, Fedorov AY.
Comparison of mechanical versus manual cardiopulmonary resuscitation in cardiac arrest
To the editor
We read with great interest the article by El-Menyar et al., titled “Mechanical versus manual cardiopulmonary resuscitation (CPR): an umbrella review of contemporary systematic reviews and more”, recently published in Critical Care [1]. The findings from the umbrella review and the new systematic review in this study suggest that mechanical CPR is not superior to manual CPR in achieving return of spontaneous circulation (ROSC).
Although this article offers valuable insights, several issues warrant further discussion and clarification. In Fig. 2’s Forest plot for ROSC from El-Menyar et al.’s article, we observed some issues with the study selection. The umbrella meta-analysis included duplicated studies [2, 3] and studies with no ROSC-related data upon our detailed review [4, 5]. Additionally, the inclusion of just the abstracts from three studies [6, 7, 8] could potentially limit the robustness of the findings. Moreover, when replicating the authors’ search strategy, we identified a missing randomized controlled trial (RCT) comparing mechanical and manual CPR in in-hospital cardiac arrest (IHCA) settings [9].
We consolidated studies from the umbrella review and the new systematic review, excluding improperly included studies and adding the newly identified RCT. Using Stata Version 16.0 (StataCorp, College Station, TX), we conducted subgroup analyses for out-of-hospital cardiac arrest (OHCA) and IHCA patients across RCTs and non-RCTs. For OHCA patients, mechanical CPR did not improve ROSC rates in either study type. However, the IHCA outcomes varied by study type: RCTs showed a higher probability of ROSC with mechanical CPR, whereas non-RCTs indicated a reduced likelihood of achieving ROSC (Figs. 1 and 2)
.
While our analysis supports the finding that mechanical CPR does not improve ROSC rates in OHCA settings, as highlighted in the meta-analysis by El-Menyar et al., the variable results for IHCA indicate a need for further investigation. In particular, the discrepancies between RCTs and non-RCTs in IHCA settings imply underlying differences that could influence CPR outcomes. These differences may include variations in patient characteristics, response times, and hospital settings. Additionally, limitations in study design, such as selection biases commonly seen in observational studies, could also be contributing factors. Further large-scale RCTs are required to determine the effectiveness of mechanical versus manual CPR in improving patient outcomes during cardiac arrest.
No datasets were generated or analysed during the current study.
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Article PubMed Google Scholar
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Article PubMed PubMed Central Google Scholar
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Authors and Affiliations
Department of Critical Care Medicine, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, 110000, China
Yang Zhao
Department of Emergency, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan East Road, Shenyang, 110000, China
Da Chen & Qian Wang
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YZ and QW were responsible for literature research, data extraction, and figure production. DC was responsible for supervision. All the authors participated in the draft writing, review, and editing.
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Zhao, Y., Chen, D. & Wang, Q. Comparison of mechanical versus manual cardiopulmonary resuscitation in cardiac arrest. Crit Care28, 319 (2024). https://doi.org/10.1186/s13054-024-05088-7
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DOI: https://doi.org/10.1186/s13054-024-05088-7
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期刊介绍:
Critical Care is an esteemed international medical journal that undergoes a rigorous peer-review process to maintain its high quality standards. Its primary objective is to enhance the healthcare services offered to critically ill patients. To achieve this, the journal focuses on gathering, exchanging, disseminating, and endorsing evidence-based information that is highly relevant to intensivists. By doing so, Critical Care seeks to provide a thorough and inclusive examination of the intensive care field.