Resuscitation Plus (Dec 2024)
Complication frequency of mechanical chest compression devices: A single-center, blinded study using retrospective data
Abstract
Aim: Use of mechanical chest compression devices for patients with cardiac arrest is increasing. As cardiopulmonary resuscitation (CPR) guidelines and LUCAS are updated, the evidence requires updating. Methods: This single-center, retrospective study observed adult patients with out-of-hospital cardiac arrest receiving CPR from emergency services. Patients were assigned to LUCAS or manual CPR groups, matched by propensity score, and evaluated through computed tomography images by a radiologist blinded to their data. The primary outcome was complications from chest compressions, and logistic regression was used to analyze their risk factors. Results: Overall, 261 patients were selected and divided into manual and LUCAS groups (n = 69 each). The manual CPR group exhibited higher witnessed cardiac arrest percentages (p = 0.023) and shorter times from scene to emergency department (p = 0.001) and total CPR duration (p = 0.002), versus the LUCAS group. Complication rates showed no significant intergroup differences in overall CPR complications (p = 0.462); however, the LUCAS group reported more hemothorax incidents (p = 0.028), versus the manual group. Logistic regression indicated that female sex (odds ratio [OR] 3.743, 95 % confidence interval [CI] 1.333–10.506), older age (OR 1.089, 95 % CI 1.048–1.132), and longer CPR durations (OR 1.045, 95 % CI 1.006–1.085) significantly correlated with compression complications, whereas LUCAS use did not (OR 0.713, 95 % CI 0.304–1.673). Conclusion: No association was observed between LUCAS use and the overall incidence of chest compression complications in adults with OHCA. LUCAS is associated with more hemothorax cases and longer transport time, versus manual CPR. Evaluating LUCAS’s benefits necessitates multiple perspectives and further research.
