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Use of automated chest compression devices after out-of-hospital cardiac arrest in Sweden.
Lund University.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0003-4139-6235
Sahlgrenska University Hospital.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
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2017 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 120, p. 95-102, article id S0300-9572(17)30603-2Article in journal (Refereed) Published
Sustainable development
The content falls within the scope of Sustainable Development
Abstract [en]

OBJECTIVE: To evaluate the implementation of automated chest compression cardiopulmonary resuscitation (ACC-CPR) after out-of-hospital cardiac arrest (OHCA) in Sweden during the years 2011 through 2015. The association between ACC-CPR and 30-day survival was studied as a secondary objective.

METHODS: The Swedish cardiopulmonary resuscitation registry is a prospectively recorded nationwide registry of modified Utstein parameters including all patients with attempted resuscitation after OHCA. Propensity score matching (PSM) was used to adjust for known confounders in the secondary analysis.

RESULTS: Of the 24,316 patients included in the study population, 32.4% received ACC-CPR, with substantial regional variation ranging from 0.8% to 78.8%. Male gender and an initial shockable rhythm were associated with ACC-CPR, whereas crew witnessed status was associated with manual CPR. Potential markers of prolonged resuscitation attempts (drug administration and endotracheal intubation) were more prevalent in the ACC-CPR group. The unadjusted 30-day survival rate was 6.3% for ACC-CPR patients. The adjusted odds ratio for 30-day survival regarding use of an ACC device was 0.72 (95% CI 0.62-0.84, p<0.001, n=13922).

CONCLUSION: The use of ACC devices varied significantly between Swedish regions and overall survival to 30days was low among patients receiving ACC-CPR. Although measured and unmeasured confounding might explain our finding of lower survival rates for patients exposed to ACC-CPR, specific guidelines recommending when and how ACC-CPR should be used are warranted as there might be circumstances where these devices do more harm than good.

Place, publisher, year, edition, pages
2017. Vol. 120, p. 95-102, article id S0300-9572(17)30603-2
Keywords [en]
Automated chest compression devices, Mechanical chest compression devices, Mechanical compressions, Out-of-hospital cardiac arrest, Outcome
National Category
Medical and Health Sciences
Research subject
Människan i vården; Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-13322DOI: 10.1016/j.resuscitation.2017.09.004ISI: 000413760500023PubMedID: 28888812Scopus ID: 2-s2.0-85029499990OAI: oai:DiVA.org:hb-13322DiVA, id: diva2:1170652
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2018-01-04Bibliographically approved

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Herlitz, JohanAxelsson, Christer

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