Effect of impedance threshold device with cardiopulmonary resuscitation in heart arrest patients: a meta-analysis

doi:10.3877/cma.j.issn.1674-6880.2016.02.008

Abstract

Abstract:

Objective

To assess the effect of impedance threshold device (ITD) with cardiopulmonary resuscitation (CPR) in heart arrest patients.

Methods

Systematic searches were conducted in PubMed, ISI WOK, Science Online, Nature, CMCC, Wangfang data, CNKI and VIP to collect clinical comparative study on whether to apply ITD from 2000 to June 2015. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted the data and evaluated the quality of the included studies. The meta-analysis was performed using Revman 5.3.

Results

Eight studies involving 138 992 heart arrest patients were included. There were no signifcant differences on the rate of return of spontaneous circulation (ROSC)[OR=1.03, 95%CI (0.96, 1.11), Z=0.93, P=0.35] between the two groups, but the rates of modified ranking scale (MRS) ≤ 3[OR=1.74, 95%CI (1.11, 2.73), Z=2.40, P=0.02] and the hospital discharge[OR=1.40, 95%CI (1.04, 1.91), Z=2.18, P=0.03] in the ITD group were much better than those in the control group. The subgroup analysis also implicated that compared with the control group, the rates of ROSC [OR=1.13, 95%CI (1.01, 1.26), Z=2.11, P=0.03], MRS ≤ 3 [OR=1.53, 95%CI (1.22, 1.93), Z=3.67, P<0.001] and hospital discharge[OR=1.25, 95%CI (1.04, 1.49), Z=2.38, P=0.02] in the ITD combined with active compression-decompression cardiopulmonary resuscitation (ACD-CPR) group increased obviously.

Conclusion

ITD combined with ACD-CPR can improve the success rate of CPR in heart arrest patients.

Key words: Impedance threshold device, Cardiopulmonary resuscitation, Heart arrest, Meta-analysis

Zhikuan Fan, Yanfen Chai, Chen Li. Effect of impedance threshold device with cardiopulmonary resuscitation in heart arrest patients: a meta-analysis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2016, 09(02): 109-115.

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References 23

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纳入研究文献	病例对照方式（例数）		年龄（岁）		男性比例（%）		改良的Jadad评分（分）
纳入研究文献	病例对照方式（例数）		ITD组	对照组	ITD组	对照组	改良的Jadad评分（分）
Plaisance等2000^[4]	ITD + ACD-CPR（11）	ACD-CPR（10）	64.0 ± 14.8	52.6 ± 24.0	63.8	80.0	7
Wolcke等2003^[5]	ITD + ACD-CPR（103）	S-CPR（107）	67.2 ± 17.2	66.8 ± 16.5	65.0	58.9	5
Plaisance等2004^[6]	ITD + ACD-CPR（200）	ACD-CPR（200）	58.0 ± 18.4	60.0 ± 18.4	66.5	66.5	5
Aufderheide等2005^[7]	ITD+ S-CPR（114）	S-CPR（116）	64.4 ± 15.4	66.5 ± 16.7	61.0	62.0	5
Pirrallo等2005^[8]	ITD + S-CPR（10）	S-CPR（12）	64.6 ± 21.3	58.3 ± 18.9	40.0	75.0	5
Aufderheide等2011^[9]	ITD + ACD-CPR（840）	S-CPR（813）	67.0 ± 15.2	66.8 ± 14.5	55.8	66.3	7
Aufderheide等2011^[10]	ITD + S-CPR（4373）	S-CPR（4345）	67.2 ± 16.4	66.6 ± 16.5	64.9	64.2	7
Frascone等2013^[11]	ITD + ACD-CPR（1403）	S-CPR（1335）	63.2 ± 17.8	64.5 ± 17.2	62.9	61.9	7

纳入研究文献	病例对照方式（例数）		年龄（岁）		男性比例（%）		改良的Jadad评分（分）
纳入研究文献	病例对照方式（例数）		ITD组	对照组	ITD组	对照组	改良的Jadad评分（分）
Plaisance等2000^[4]	ITD + ACD-CPR（11）	ACD-CPR（10）	64.0 ± 14.8	52.6 ± 24.0	63.8	80.0	7
Wolcke等2003^[5]	ITD + ACD-CPR（103）	S-CPR（107）	67.2 ± 17.2	66.8 ± 16.5	65.0	58.9	5
Plaisance等2004^[6]	ITD + ACD-CPR（200）	ACD-CPR（200）	58.0 ± 18.4	60.0 ± 18.4	66.5	66.5	5
Aufderheide等2005^[7]	ITD+ S-CPR（114）	S-CPR（116）	64.4 ± 15.4	66.5 ± 16.7	61.0	62.0	5
Pirrallo等2005^[8]	ITD + S-CPR（10）	S-CPR（12）	64.6 ± 21.3	58.3 ± 18.9	40.0	75.0	5
Aufderheide等2011^[9]	ITD + ACD-CPR（840）	S-CPR（813）	67.0 ± 15.2	66.8 ± 14.5	55.8	66.3	7
Aufderheide等2011^[10]	ITD + S-CPR（4373）	S-CPR（4345）	67.2 ± 16.4	66.6 ± 16.5	64.9	64.2	7
Frascone等2013^[11]	ITD + ACD-CPR（1403）	S-CPR（1335）	63.2 ± 17.8	64.5 ± 17.2	62.9	61.9	7

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