Association of Mechanical Cardiopulmonary Resuscitation Device Use With Cardiac Arrest Outcomes
A Population-Based Study Using the CARES Registry (Cardiac Arrest Registry to Enhance Survival)
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The use of mechanical cardiopulmonary resuscitation devices (mCPR) to deliver CPR has become more widespread, although a survival advantage has not been demonstrated in randomized, controlled trials.1–3 Little is known about real-world use of mCPR or the association with outcomes.
CARES (Cardiac Arrest Registry to Enhance Survival), a US national registry of out-of-hospital cardiac arrest,4 was analyzed for adults with nontraumatic out-of-hospital cardiac arrest from January 2013 to December 2015. Patients treated with mCPR were compared with patients receiving manual CPR only. Time of arrest, time of first CPR, and timing of interventions were not reliably reported. However, patients had information about when return of spontaneous circulation (ROSC) occurred before or after advanced life support (ALS) measures. As part of a subgroup analysis, patients with ROSC before ALS were excluded because of the decreased likelihood of these patients receiving mCPR. The primary outcome of interest was neurologically favorable survival at hospital discharge, defined as a Cerebral Performance Category of 1 or 2. This project was deemed exempt from review by the Children’s Hospital of Philadelphia and University of Pennsylvania Institutional Review boards.
Statistical analyses included the Student t test and χ2 test as appropriate. A multivariable logistic regression model was created with the use of stepwise addition to control for Utstein-style arrest characteristics, …