Dissertation Nursing
Par Sara Rizzo, Domitilla Nistri, Mauro Carmine Martucci et 3 autres.
Contenu en anglais
Mechanical chest compression devices deliver consistent compressions, but their clinical benefit over manual cardiopulmonary resuscitation (CPR) and their safety profile remain debated.
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To evaluate the effect of mechanical compression compared with manual CPR on survival (primary objective), return of spontaneous circulation (ROSC), neurological outcome, CPR-related injuries, and compression quality in adults with non-traumatic cardiac arrest.
A systematic review was conducted according to PRISMA 2020. The search was performed on October 13, 2026, in PubMed, Scopus, and the Cochrane Library. Risk of bias was assessed with the JBI tools and certainty of evidence with the GRADE approach; results were synthesized narratively.
Thirty studies were included: 6 randomized trials, 4 quasi-experimental, 14 cohort, 1 case-control, 4 cross-sectional studies, and 1 case series. In randomized trials, mechanical compression did not improve survival and ROSC (moderate certainty) or neurological outcome (low certainty). Observational studies, exposed to confounding by indication, yielded discordant results (very low certainty). Visceral injuries were more frequent with the devices (very low certainty). In simulations, the devices maintained consistent compressions during transport.
Mechanical compression is not superior to high-quality manual CPR. Its use appears justified in settings where manual CPR is not practicable or exposes rescuers to risk, within shared protocols and trained teams.
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