Effectiveness of Mechanical Active Compression-Decompression Cardiopulmonary Resuscitation (ACD-CPR): A Meta-Analysis

Thursday, 2 August 2012: 3:55 PM

Mei-Chin Huang, BSN, RN1
Yu-Xuan Wang, BSN, RN1
Yueh-Yen Fang, PhD, RN2
(1)Department of Nursing, Kaohsiung Municipal Ta-Tung Hospital - An affiliation of Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan
(2)School of Nursing, Fooyin University, Kaohsiung, Taiwan

Learning Objective 1: The learner will be able to describe effectiveness of mechanical ACD-CPR.

Learning Objective 2: The learner will be able to describe factors that may impede study quality of mechanical ACD-CPR research.

Purpose: The purposes of this study were to examine the effectiveness of mechanical ACD-CPR and factors that might impede study quality of mechanical ACD-CPR research. 

Methods: A meta-analysis with random-effects model was conducted to answer the research questions. The pooled estimate provided an odds ratio of the survival rate based on the comparison between the mechanical ACD-CPR and the manual CPR. Five English and three Chinese databases were used to search English and Chinese literature published up to April, 2011. The search term used was ‘mechanical and manual and CPR.’ Research articles that provided comparisons on human survival rate between mechanical and manual CPR were included for analysis. Data were extracted by two researchers independently. Disagreement among data extraction was resolved by complete consensus between researchers. Study quality was evaluated by the Johns Hopkins Nursing Evidence-based practice Quality Rating Scale. 

Results: From 2724 citations, seven randomized controlled trials (RCTs) and two nonrandomized controlled trials (NRCT) met the inclusion criteria. The total subjects involved in the analysis were 1669 patients. Study quality of included studies ranged from IA to IIA. Results showed there was no survival rate difference between mechanical and manual CPR (WES = 1.22, 95% CI = .93-1.59). Studies presented consistent distributions among study outcomes (Q = 10.07, p = .26) and between RCT and NRCT designs (QB = .09, p = .76). 

Conclusion: The meta-analysis supported that mechanical and manual CPR provided same survival chance. However, included studies did not control or record the time between cardiac arrest and CPR. The survival rate may also be influenced by the disease severity. It is suggested that future studies provide a better control and report of these two issues. Based on the current evidence, mechanical ACD-CPR is suggested to be a considerable method for replacing manual CPR.