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Efficacy of heads‐up CPR compared to supine CPR positions: Systematic review and meta‐analysis
BACKGROUND AND AIM: Cardiopulmonary resuscitation (CPR) in full‐coded patients requires effective chest compressions with minimal interruptions to maintain adequate perfusion to the brain and other vital organs. Many novel approaches have been proposed to attain better organ perfusion compared to tr...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9128396/ https://www.ncbi.nlm.nih.gov/pubmed/35620549 http://dx.doi.org/10.1002/hsr2.644 |
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author | Varney, Joseph Motawea, Karam R. Mostafa, Mostafa R. AbdelQadir, Yossef H. Aboelenein, Merna Kandil, Omneya A. Ibrahim, Nancy Hashim, Hashim T. Murry, Kimberly Jackson, Garrett Shah, Jaffer Boury, Maty Awad, Ahmed K. Patel, Priya Awad, Dina M. Rozan, Samah S. Talat, Nesreen E. |
author_facet | Varney, Joseph Motawea, Karam R. Mostafa, Mostafa R. AbdelQadir, Yossef H. Aboelenein, Merna Kandil, Omneya A. Ibrahim, Nancy Hashim, Hashim T. Murry, Kimberly Jackson, Garrett Shah, Jaffer Boury, Maty Awad, Ahmed K. Patel, Priya Awad, Dina M. Rozan, Samah S. Talat, Nesreen E. |
author_sort | Varney, Joseph |
collection | PubMed |
description | BACKGROUND AND AIM: Cardiopulmonary resuscitation (CPR) in full‐coded patients requires effective chest compressions with minimal interruptions to maintain adequate perfusion to the brain and other vital organs. Many novel approaches have been proposed to attain better organ perfusion compared to traditional CPR techniques. The purpose of this review is to investigate the safety and efficacy of heads‐up CPR versus supine CPR. METHODS: We searched PubMed Central, SCOPUS, Web of Science, and Cochrane databases from 1990 to February 2021. After the full‐text screening of 40 eligible studies, only seven studies were eligible for our meta‐analysis. We used the RevMan software (5.4) to perform the meta‐analysis. RESULTS: In survival outcome, the pooled analysis between heads‐up and supine CPR was (risk ratio = 0.98, 95% confidence interval [CI] = 0.17–5.68, p = 0.98). The pooled analyses between heads‐up CPR and supine CPR in cerebral flow, cerebral perfusion pressure and coronary perfusion pressure outcomes, were (mean difference [MD] = 0.10, 95% CI = 0.03–0.17, p = 0.003), (MD = 12.28, 95% CI = 5.92–18.64], p = 0.0002), and (MD = 8.43, 95% CI = 2.71–14.14, p = 0.004), respectively. After doing a subgroup analysis, cerebral perfusion was found to increase during heads‐up CPR compared with supine CPR at 6 min CPR duration and 18 to 20 min CPR duration as well. CONCLUSION: Our study suggests that heads‐up CPR is associated with better cerebral and coronary perfusion compared to the conventional supine technique in pigs' models. However, more research is warranted to investigate the safety and efficacy of the heads‐up technique on human beings and to determine the best angle for optimization of the technique results. |
format | Online Article Text |
id | pubmed-9128396 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91283962022-05-25 Efficacy of heads‐up CPR compared to supine CPR positions: Systematic review and meta‐analysis Varney, Joseph Motawea, Karam R. Mostafa, Mostafa R. AbdelQadir, Yossef H. Aboelenein, Merna Kandil, Omneya A. Ibrahim, Nancy Hashim, Hashim T. Murry, Kimberly Jackson, Garrett Shah, Jaffer Boury, Maty Awad, Ahmed K. Patel, Priya Awad, Dina M. Rozan, Samah S. Talat, Nesreen E. Health Sci Rep Original Research BACKGROUND AND AIM: Cardiopulmonary resuscitation (CPR) in full‐coded patients requires effective chest compressions with minimal interruptions to maintain adequate perfusion to the brain and other vital organs. Many novel approaches have been proposed to attain better organ perfusion compared to traditional CPR techniques. The purpose of this review is to investigate the safety and efficacy of heads‐up CPR versus supine CPR. METHODS: We searched PubMed Central, SCOPUS, Web of Science, and Cochrane databases from 1990 to February 2021. After the full‐text screening of 40 eligible studies, only seven studies were eligible for our meta‐analysis. We used the RevMan software (5.4) to perform the meta‐analysis. RESULTS: In survival outcome, the pooled analysis between heads‐up and supine CPR was (risk ratio = 0.98, 95% confidence interval [CI] = 0.17–5.68, p = 0.98). The pooled analyses between heads‐up CPR and supine CPR in cerebral flow, cerebral perfusion pressure and coronary perfusion pressure outcomes, were (mean difference [MD] = 0.10, 95% CI = 0.03–0.17, p = 0.003), (MD = 12.28, 95% CI = 5.92–18.64], p = 0.0002), and (MD = 8.43, 95% CI = 2.71–14.14, p = 0.004), respectively. After doing a subgroup analysis, cerebral perfusion was found to increase during heads‐up CPR compared with supine CPR at 6 min CPR duration and 18 to 20 min CPR duration as well. CONCLUSION: Our study suggests that heads‐up CPR is associated with better cerebral and coronary perfusion compared to the conventional supine technique in pigs' models. However, more research is warranted to investigate the safety and efficacy of the heads‐up technique on human beings and to determine the best angle for optimization of the technique results. John Wiley and Sons Inc. 2022-05-24 /pmc/articles/PMC9128396/ /pubmed/35620549 http://dx.doi.org/10.1002/hsr2.644 Text en © 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research Varney, Joseph Motawea, Karam R. Mostafa, Mostafa R. AbdelQadir, Yossef H. Aboelenein, Merna Kandil, Omneya A. Ibrahim, Nancy Hashim, Hashim T. Murry, Kimberly Jackson, Garrett Shah, Jaffer Boury, Maty Awad, Ahmed K. Patel, Priya Awad, Dina M. Rozan, Samah S. Talat, Nesreen E. Efficacy of heads‐up CPR compared to supine CPR positions: Systematic review and meta‐analysis |
title | Efficacy of heads‐up CPR compared to supine CPR positions: Systematic review and meta‐analysis |
title_full | Efficacy of heads‐up CPR compared to supine CPR positions: Systematic review and meta‐analysis |
title_fullStr | Efficacy of heads‐up CPR compared to supine CPR positions: Systematic review and meta‐analysis |
title_full_unstemmed | Efficacy of heads‐up CPR compared to supine CPR positions: Systematic review and meta‐analysis |
title_short | Efficacy of heads‐up CPR compared to supine CPR positions: Systematic review and meta‐analysis |
title_sort | efficacy of heads‐up cpr compared to supine cpr positions: systematic review and meta‐analysis |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9128396/ https://www.ncbi.nlm.nih.gov/pubmed/35620549 http://dx.doi.org/10.1002/hsr2.644 |
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