A review of randomized clinical trials comparing mechanical cardiopulmonary resuscitation (CPR) devices to manual chest compressions has failed to demonstrated that one is superior to the other. The systematic review, which analyzed data from four trials involving a total of 868 patients, appears in The Cochrane Library.

Although animal research, anecdotal reports, and studies of small series of patients suggested that mechanical CPR devices are more effective than manual chest compression, a systematic review of quality clinical research had not yet been done, according to the Cochrane review researchers. The only large recent study found that patients treated with a mechanical device fared more poorly. Yet, problems in how the study took place might explain these unexpected results, the Cochrane reviews said.

The Cochrane review found that the findings of those studies were inconsistent—the three small studies suggested mechanical devices were beneficial, and the one large study found harm. According to the Cochrane review, taken together, they provided “insufficient evidence” to draw meaningful conclusions.

Robert E. O’Connor, MD, chair of emergency medicine at University of Virginia, called the review “extremely well done,” and said that “even though it didn’t completely answer the question, it gives future investigators some direction for CPR studies in general.”

He proposed that the question is not “whether the devices work—in the laboratory they do—but whether you can get them on quickly enough without interrupting chest compression for any length of time. You pay a price for applying any device. The question is whether the price is worth it.”

According to Steven C. Brooks, MD, assistant professor of medicine at University of Toronto and lead review author, a much larger international study comparing manual and mechanical chest compressions, scheduled for completion in 2012, should provide more definitive answers.

Source: Health Behavior News Service