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A Systematic Review and Meta-Analysis of the Implementation of High-Performance Cardiopulmonary Resuscitation on Out-of-Hospital Cardiac Arrest Outcomes
Despite numerous technological and medical advances, out-of-hospital cardiac arrests (OHCAs) still suffer from suboptimal survival rates and poor subsequent neurological and functional outcomes amongst survivors. Multiple studies have investigated the implementation of high-quality prehospital resus...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152988/ https://www.ncbi.nlm.nih.gov/pubmed/34068157 http://dx.doi.org/10.3390/jcm10102098 |
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author | Ng, Qin Xiang Han, Ming Xuan Lim, Yu Liang Arulanandam, Shalini |
author_facet | Ng, Qin Xiang Han, Ming Xuan Lim, Yu Liang Arulanandam, Shalini |
author_sort | Ng, Qin Xiang |
collection | PubMed |
description | Despite numerous technological and medical advances, out-of-hospital cardiac arrests (OHCAs) still suffer from suboptimal survival rates and poor subsequent neurological and functional outcomes amongst survivors. Multiple studies have investigated the implementation of high-quality prehospital resuscitative efforts, and across these studies, different terms describing high-quality resuscitative efforts have been used, such as high-performance CPR (HP CPR), multi-tiered response (MTR) and minimally interrupted cardiac resuscitation (MICR). There is no universal definition for HP CPR, and dissimilar designs have been employed. This systematic review thus aimed to review current evidence on HP CPR implementation and examine the factors that may influence OHCA outcomes. Eight studies were systematically reviewed, and seven were included in the final meta-analysis. Random-effects meta-analysis found a significantly improved likelihood of prehospital return of spontaneous circulation (pooled odds ratio (OR) = 1.46, 95% CI: 1.16 to 1.82, p < 0.001), survival-to-discharge (pooled OR = 1.32, 95% CI: 1.16 to 1.50, p < 0.001) and favourable neurological outcomes (pooled OR = 1.24, 95% CI: 1.11 to 1.39, p < 0.001) with HP CPR or similar interventions. However, the studies had generally high heterogeneity (I(2) greater than 50%) and overall moderate-to-severe risk for bias. Moving forward, a randomised, controlled trial is necessary to shed light on the subject. |
format | Online Article Text |
id | pubmed-8152988 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-81529882021-05-27 A Systematic Review and Meta-Analysis of the Implementation of High-Performance Cardiopulmonary Resuscitation on Out-of-Hospital Cardiac Arrest Outcomes Ng, Qin Xiang Han, Ming Xuan Lim, Yu Liang Arulanandam, Shalini J Clin Med Article Despite numerous technological and medical advances, out-of-hospital cardiac arrests (OHCAs) still suffer from suboptimal survival rates and poor subsequent neurological and functional outcomes amongst survivors. Multiple studies have investigated the implementation of high-quality prehospital resuscitative efforts, and across these studies, different terms describing high-quality resuscitative efforts have been used, such as high-performance CPR (HP CPR), multi-tiered response (MTR) and minimally interrupted cardiac resuscitation (MICR). There is no universal definition for HP CPR, and dissimilar designs have been employed. This systematic review thus aimed to review current evidence on HP CPR implementation and examine the factors that may influence OHCA outcomes. Eight studies were systematically reviewed, and seven were included in the final meta-analysis. Random-effects meta-analysis found a significantly improved likelihood of prehospital return of spontaneous circulation (pooled odds ratio (OR) = 1.46, 95% CI: 1.16 to 1.82, p < 0.001), survival-to-discharge (pooled OR = 1.32, 95% CI: 1.16 to 1.50, p < 0.001) and favourable neurological outcomes (pooled OR = 1.24, 95% CI: 1.11 to 1.39, p < 0.001) with HP CPR or similar interventions. However, the studies had generally high heterogeneity (I(2) greater than 50%) and overall moderate-to-severe risk for bias. Moving forward, a randomised, controlled trial is necessary to shed light on the subject. MDPI 2021-05-13 /pmc/articles/PMC8152988/ /pubmed/34068157 http://dx.doi.org/10.3390/jcm10102098 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ng, Qin Xiang Han, Ming Xuan Lim, Yu Liang Arulanandam, Shalini A Systematic Review and Meta-Analysis of the Implementation of High-Performance Cardiopulmonary Resuscitation on Out-of-Hospital Cardiac Arrest Outcomes |
title | A Systematic Review and Meta-Analysis of the Implementation of High-Performance Cardiopulmonary Resuscitation on Out-of-Hospital Cardiac Arrest Outcomes |
title_full | A Systematic Review and Meta-Analysis of the Implementation of High-Performance Cardiopulmonary Resuscitation on Out-of-Hospital Cardiac Arrest Outcomes |
title_fullStr | A Systematic Review and Meta-Analysis of the Implementation of High-Performance Cardiopulmonary Resuscitation on Out-of-Hospital Cardiac Arrest Outcomes |
title_full_unstemmed | A Systematic Review and Meta-Analysis of the Implementation of High-Performance Cardiopulmonary Resuscitation on Out-of-Hospital Cardiac Arrest Outcomes |
title_short | A Systematic Review and Meta-Analysis of the Implementation of High-Performance Cardiopulmonary Resuscitation on Out-of-Hospital Cardiac Arrest Outcomes |
title_sort | systematic review and meta-analysis of the implementation of high-performance cardiopulmonary resuscitation on out-of-hospital cardiac arrest outcomes |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152988/ https://www.ncbi.nlm.nih.gov/pubmed/34068157 http://dx.doi.org/10.3390/jcm10102098 |
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