Outcomes after Mechanical versus Manual Chest Compressions in eCPR Patients

Background: Extracorporeal cardiopulmonary resuscitation (eCPR) is an established treatment option for cardiac arrest. Mechanical reanimation devices are increasingly used, but have been associated with complications. This study aims to evaluate typical injury patterns and differences after mechanical versus manual chest compressions among patients undergoing eCPR.

Method: From 2016 to 2020, a total of 108 eCPR patients were retrospectively analyzed. Primary endpoints were traumatic, hemorrhagic, or inner organ-related complications, defined as pneumothorax, pulmonary bleeding, major bleeding, gastrointestinal bleeding, gastrointestinal ischemia, cardiac tamponade, aortic dissection, sternal or rib fracture. In-hospital mortality was defined as secondary endpoint.

Results: A total of 70 patients were treated with mechanical CPR (mCPR) and 38 with conventional CPR (cCPR). There were more CPR-related injuries in the mCPR group (55% vs. 83%, p = 0.01), CPR duration was longer (cCPR 40 ± 28 minutes vs. mCPR 69 ± 25 minutes, p = 0.01). Brain death occurred more often in the mCPR group (41 vs. 21%, p = 0.01), but there was no significant difference in mortality.

Conclusion: Mechanical CPR devices are associated with a higher incidence of traumatic and hemorrhagic injuries in patients undergoing eCPR. These injuries are not associated with higher in-hospital mortality compared with conventional chest compressions.

Publication History

Article published online:
03 February 2022