Active chest compression-decompression (ACDR)66. Lafuente-Lafuente C, Melero-Bascones M. Active chest compression-decompression for cardiopulmonary resuscitation. Cochrane Database Syst Rev. 2013;(9):CD002751. PMID: 24052483; doi: 10.1002/14651858.CD002751.pub3. https://doi.org/10.1002/14651858.CD00275...
|
Standard cardiopulmonary resuscitation (SCR) |
Out-of-hospital or in-hospital cardiac arrest patients |
Similar results were found for out-of-hospital and in-hospital cardiac arrest: there were no differences between the groups regarding mortality up to hospital discharge, neurological impairment or complications (such as fractures and pneumothorax and hemothorax). |
Not assessed |
Mechanical chest compression1010. Brooks SC, Hassan N, Bigham BL, Morrison LJ. Mechanical versus manual chest compressions for cardiac arrest. Cochrane Database Syst Rev. 2014;(2):CD007260. PMID: 24574099; doi: 10.1002/14651858.CD007260.pub3. https://doi.org/10.1002/14651858.CD00726...
|
Manual (standard) chest compression |
Cardiac arrest patients |
One RCT found improved neurological function and survival until hospital discharge, favoring mechanical chest compression. This result was inconsistent with others included in the RCT but no quantitative synthesis was performed because of heterogeneity of the data. |
Very low to moderate |
Continuous chest compression1212. Zhan L, Yang LJ, Huang Y, He Q, Liu GJ. Continuous chest compression versus interrupted chest compression for cardiopulmonary resuscitation of non-asphyxial out-of-hospital cardiac arrest. Cochrane Database Syst Rev. 2017;3:CD010134. PMID: 28349529; doi: 10.1002/14651858.CD010134.pub2. https://doi.org/10.1002/14651858.CD01013...
|
Interrupted chest compression |
Non-asphyxial out-of-hospital cardiac arrest |
When performed by an untrained person, continuous chest compression achieved higher rates of survival until hospital discharge but no difference in neurological outcomes. When performed by a trained person, there was no difference between the groups regarding survival or neurological outcomes. |
Moderate to high |
Defibrillation |
Intervention |
Comparators |
Population |
Main findings |
GRADE1717. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328(7454):1490. PMID: 15205295.
|
Biphasic transthoracic defibrillation88. Faddy SC, Jennings PA. Biphasic versus monophasic waveforms for transthoracic defibrillation in out-of-hospital cardiac arrest. Cochrane Database Syst Rev. 2016;2:CD006762. PMID: 26904970; doi: 10.1002/14651858.CD006762.pub2. https://doi.org/10.1002/14651858.CD00676...
|
Monophasic transthoracic defibrillation |
Out-of-hospital cardiac arrest |
No difference between the groups regarding survival until hospital discharge. No difference regarding failure to defibrillate and return of spontaneous circulation. |
Not assessed |
Delayed defibrillation1313. Huang Y, He Q, Yang LJ, Liu GJ, Jones A. Cardiopulmonary resuscitation (CPR) plus delayed defibrillation versus immediate defibrillation for out-of-hospital cardiac arrest. Cochrane Database Syst Rev. 2014;(9):CD009803. PMID: 25212112; doi: 10.1002/14651858.CD009803.pub2. https://doi.org/10.1002/14651858.CD00980...
|
Immediate defibrillation |
Out-of-hospital cardiac arrest |
No difference between the groups was found regarding survival until hospital discharge, good neurological outcome and return of spontaneous circulation. |
Low |
Other interventions |
Intervention |
Comparators |
Population |
Main findings |
GRADE1717. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328(7454):1490. PMID: 15205295.
|
Aminophylline99. Hurley KF, Magee K, Green R. Aminophylline for bradyasystolic cardiac arrest in adults. Cochrane Database Syst Rev. 2015;(11):CD006781. PMID: 26593309; doi: 10.1002/14651858.CD006781.pub3. https://doi.org/10.1002/14651858.CD00678...
|
No intervention |
Bradyasystolic cardiac arrest |
No difference between the groups regarding survival until hospital discharge and return of spontaneous circulation. |
Low to high |
Pre-hospital cooling77. Arrich J, Holzer M, Havel C, Warenits AM, Herkner H. Pre-hospital versus in-hospital initiation of cooling for survival and neuroprotection after out-of-hospital cardiac arrest. Cochrane Database Syst Rev. 2016;3:CD010570. PMID: 26978162; doi: 10.1002/14651858.CD010570.pub2. https://doi.org/10.1002/14651858.CD01057...
|
In-hospital cooling |
Cardiac arrest patients |
There was a lack of data for quantitative synthesis, but the individual RCTs included did not find differences between the groups. |
Very low |
Hypothermia1111. Arrich J, Holzer M, Havel C, Müllner M, Herkner H. Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation. Cochrane Database Syst Rev. 2016;2:CD004128. PMID: 26878327; doi: 10.1002/14651858.CD004128.pub4. https://doi.org/10.1002/14651858.CD00412...
|
No intervention |
Cardiac arrest patients |
Conventional cooling was more likely to achieve a positive neurological outcome, increased survival and higher rates of adverse events (pneumonia and hypokalemia). |
Low to moderate |
Emergency intubation1414. Lecky F, Bryden D, Little R, Tong N, Moulton C. Emergency intubation for acutely ill and injured patients. Cochrane Database Syst Rev. 2008;(2):CD001429. PMID: 18425873; doi: 10.1002/14651858.CD001429.pub2. https://doi.org/10.1002/14651858.CD00142...
|
Other airway management techniques (bag-valve-mask ventilation, esophageal gastric tube or combi-tube) |
Acutely ill and injured patients |
For the comparison ETI versus bag-valve-mask ventilation and subsequently ETI, there was no difference between the groups regarding survival and good neurological outcome at hospital discharge. For the comparisons ETI versus esophageal gastric tube and ETI versus combi-tube, there was no difference in survival between the groups at hospital discharge. |
Not assessed |