PARAMEDIC 2015 - LUCAS
✤ Multi-centre cluster RCT
✤ 4471 patients.
✤ Survival 30 days
✤ Mechanical CPR showed no
Survival to discharge
Survival with CPC 1 or 2
MECCA 2017 - LUCAS
✤ Multi-centre RCT
✤ 1191 patients.
Survival to discharge
✤ As treated analysis
Early LUCAS 5.8%
Late LUCAS 2%
ANZCOR suggests against the routine use of automated mechanical chest
compression devices to replace manual chest compressions (CoSTR 2015 weak
recommendation, moderate quality of evidence).2
ANZCOR suggests that automated mechanical chest compression devices are a
reasonable alternative to high-quality manual chest compressions in situations
where sustained high- quality manual chest compressions are impractical or
compromise provider safety (CoSTR 2015, weak recommendation, low quality
When is it
✤ Limited rescuers
✤ Prolonged CPR
When are they
not so useful?
✤ Poor placement
✤ Further Research
Early use of mechanical
In hospital use
1. Hightower D, Thomas SH, Stone CK, et al. Decay in quality of closed-chest compressions over time. Annals of emergency medicine. 1995;
2. Ochoa FJ, Ramalle-Gómara E, Lisa V, et al. The effect of rescuer fatigue on the quality of chest compressions. Resuscitation. 1998; 37(3):149-52
3. Idris AH, Guffey D, Pepe PP, et al. Chest compression rates and survival following out-of-hospital cardiac arrest. Crit Care Med 2015;43:840–8.
4. Stiell IG, Brown SP, Christenson J, et al. What is the role of chest compression depth during out-of-hospital cardiac arrest resuscitation? Crit Care
5. Cheskes S, Schmicker R, Christenson J et al. Peri-shock pause: an independent predictor of survival from out-of-hospital shockable cardiac arrest.
6. Preethi W, Rao P, Kanakadandi UB, et al. Mechanical cardiopulmonary resuscitation in and on the way to the cardiac catheterization laboratory. Circ
J 2016; 80: 1292–1299.
7. Wagner H, Terkelsen CJ, Friberg H, et al. Cardiac arrest in the catheterisation laboratory: a 5-year experience of using mechanical chest
compressions to facilitate PCI during prolonged resuscitation efforts. Resuscitation 2010; 81: 383–387.
8. Wagner H, Hardig BM, Rundgren M, et al. Mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary
intervention and sur- vival in patients requiring prolonged resuscitation efforts. Scand J Trauma Resusc Emerg Med 2016; 24: 4
9. Stub D, Bernard S, Pellegrino V, et al. Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the
CHEER trial). Resus- citation 2015; 86: 88–94.