Comparison of Sustained Return of Spontaneous Circulation Rate Between Manual and Mechanical Chest Compression in Adult Cardiac Arrest

OBJECTIVE: This study aimed to compare the rates of sustained return of spontaneous circulation (ROSC) between manual and mechanical chest compression in adult non-traumatic cardiac arrest. METHODS: A retrospective cohort study was conducted from 2017 to 2019. The medical records were reviewed in 227 cardiac arrest patients aged ≥18 years who experienced out-of-hospital cardiac arrest or cardiac arrest while visiting the emergency department (ED). The patients were divided into manual chest compression and mechanical chest compression groups. The two groups were compared in terms of baseline characteristics, time to arrive at the ED, time to basic life support, initial rhythm, time to defibrillation in the shockable group, time to the first dose of adrenaline, and possible cause of arrest. A multivariate logistic regression model was used to determine the factors associated with ROSC. RESULTS: A total of 227 patients met the inclusion criteria:193 patients in the manual chest compression group and 34 patients in the mechanical chest compression group. The rate of sustained ROSC in the manual chest compression group was higher (43% vs 8.8%; P < 0.001). The significant factors associated with ROSC were witnessed cardiac arrest (odds ratio (OR) = 3.41; 95% confidence interval (CI) 0.94–12.4), ED arrival by basic ambulance service (OR = 1.93; 95% CI 0.86–4.35), cardiac arrest at the ED (OR = 3.69; 95% CI 1.73–7.88), and cardiac arrest from hypoxia (OR = 2.01; 95% CI 1.02–3.97). CONCLUSION: Mechanical chest compression was not associated with sustained ROSC and tended to be selectively used in patients with a prolonged duration of cardiac arrest.