Document Type : Original Article
Authors
1
Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine, Tanta University, Egypt.
2
Cardiology, Al Jufairi Diagnosis and Treatment, MOH, Qatar
3
Anesthesia, ICU and Perioperative Medicine Department, Hamad Medical Corporation, Doha, Qatar Clinical Anesthesiology Department, Weill Cornell Medical College in Qatar, Doha, Qatar Clinical Anesthesiology Department, College of Medicine
4
Internal Medicine - Mansoura University Hospital, Egypt.
5
Internal Medicine - Mansoura General Hospital, Egypt.
6
Department of Emergency Medicine, Hamad Medical Corporation; Department of Emergency Medicine, College of Medicine, Qatar University, Doha, Qatar.
7
Hamad Medical Corporation, Department of Emergency Medicine - Doha - Qatar Blizard Institute, Queen Mary University, London, UK
8
Department of Emergency Medicine, College of Medicine, Qatar University, Doha, Qatar.
10.21608/egja.2025.370141.1035
Abstract
Background
Mechanical chest compression devices have gained interest in resuscitation science because they have the capability to continuously provide high-quality CPR and improve outcomes. However, evidence has shown mixed results on their effectiveness. Therefore, the current review was constructed to determine whether the introduction of the Lund University Cardiac Assist System (LUCAS) as a subtype of mechanical CPR can improve the outcomes of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) compared with manual CPR.
Methods
An extended search for studies relevant to our study was performed on five electronic databases (PubMed, Scopus, ScienceDirect, Medline, and Google Scholar). Quality appraisal of eligible randomized studies was performed using Cochrane’s risk of bias tool, while the Newcastle Ottawa scale was used for the evaluation of observational studies. Moreover, the RevMan software (version.5.4.1) was used to perform all meta-analyses.
Results
Our extensive search yielded 2409 articles, of which only 18 (7 Randomized controlled trials (RCTs) and 11 observational studies) were eligible for inclusion and analysis. Both RCTs and observational studies have shown that in non-traumatic OHCA patients, pre-hospital CPR with LUCAS was not superior to manual CPR in terms of return to spontaneous circulation (ROSC), survival to hospital admission (SHA), survival to hospital discharge (SHD), and discharge with good neurological outcome. Similarly, in patients with OHCA or IHCA, in-hospital LUCAS mechanical CPR did not demonstrate superiority over manual chest compression, as shown by the ROSC and SHD outcomes. In addition, LUCAS did not improve ROSC and SHD endpoints in patients exhibiting non-shockable rhythms. Furthermore, a subgroup analysis for CPR-related injuries showed that LUCAS mechanical CPR did not pose a significant risk for rib fractures, hemothorax, or pneumothorax compared to manual compression. However, it was associated with an increased risk for sternal injuries as indicated by outcomes in three observational studies.
Conclusions
In patients with IHCA or OHCA, LUCAS is not more effective than manual compression. Moreover, observational studies suggest that LUCAS might be associated with more sternal fractures. As a result, we are unable to endorse or contradict the adoption LUCAS as first-line intervention for cardiac arrest patients.
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