Mechanical Chest Compression: Efficacy in Survival Rate

The study investigated the effectiveness of mechanical chest compression, specifically LUCAS-2, in increasing survival rates compared to manual chest compression methods. The results showed that there was no significant difference in 30-day survival rates between the two methods. Additionally, 15% of complexities during the research were due to introducing mechanical CPR as opposed to manual technique.

Medical case study

Table of Contents
Aim..................................................................................................................................................3
Type of Study...................................................................................................................................3
Setting..............................................................................................................................................3
Population........................................................................................................................................3
Methodology....................................................................................................................................3
Analysis...........................................................................................................................................4
Results and Findings........................................................................................................................4
Discussion and Level of Evidence...................................................................................................5
REFERENCES.....................................................................................................................................6

Aim
“Whether the introduction of LUCAS-2 mechanical CPR into front-line emergency response
vehicles would improve
survival from out-of-hospital cardiac arrest.”
Type of Study
The study was conducted with the help of randomised control trials with the services offered
by vehicles as the main unit of randomisation (Gässler and et.al, 2015). The overall study was
conducted in partnership with 4 UK based national healthcare service centres. Individual patient
were selected in the study if the travel ambulance was recorded to be the first vehicle to be present
on the scene. The ambulance service was directed to present all the data recorded through the
variables of cardiac arrest to central trail databases. The enrolment procedure proceeded with the
help of consent form under the mental capacity Act 2005 (Steinberg and et.al, 2016).
Setting
Even though mechanical chest compression has recorded to produce high potential of
maintaining cardiopulmonary resuscitation but the result drawn from various researches are not able
to justify the effectiveness of use of mechanical chest in retaining the cardiopulmonary rate in
individuals who have encountered cardiac arrest (Kugytė and Šliburytė, 2015). The overall research
is based on the study that whether the use of LUCAS-2 mechanical CPR in front-line emergency
response vehicle would probably increase the survival rate of patient who has undergone out of
hospital cardiac arrest.
Population
The study enrolled a total of 4471 eligible patients which were categorized into two different
groups (Rothwell and et.al, 2012). Out of the selected participants 1652 individuals were directed to
mechanical chest compression with the help of LUCAS-2 and 2819 people were directed to join the
control group. Out of 1652 patients 60% of them received mechanical chest compression whereas
11% of them received LUCAS-2 from the control group. Overall 91 ambulance station were
selected depending upon the locations so that they are able to coordinate in emergency response
(Perkins and et.al, 2015). The vehicles were dispatched to the places were there were immediate
chances of cardiac arrest in the patients (Vasylev and et.al, 2013). All the patients who have been
discharged from the hospital were informed prior to the research so that they are able to participate
in the ongoing study. A consent information form was being filled by all the population so that they
can take part in follow up trials after 3-12 months of cardiac arrest.
Methodology
The overall study is based on randomised control trials for the assessment of mechanical
compression device in the case of cardiac arrest. It was a cluster based open label trial where non

traumatic out-of-hospital cardiac arrest patients were chosen (Wilfond and et.al, 2015). The
ambulance services was provided by 4 UK based national healthcare services which were selected
from West Midlands, North East England, Wales and South Central. Among these four areas, 91
regions form urban and semi-urban localities were selected. Cluster were the ambulatory vehicles
which were assigned to deliver mechanical as well as manual chest compression resuscitation.
According to the arrival of first trial ambulance on the scene patients were either subjected to
mechanical chest compression or manual CPR (Taylor, Bogdan and DeVault, 2015). Primary
outcomes was monitored with the intension to treat all the patients who have encountered cardiac
arrest. All the staff members who were present in the ambulance were masked. The study was
registered under Current
Controlled Trials, number ISRCTN08233942
Analysis
The target sample size which was selected in randomised control trial was again revised in
September 2012 after the selection of 2469 patients (Kaya, Catic and Bergsjo, 2014). After updating
the information about the frequency of LUCAS-2 trial steering committee and Monitoring
committee decided to increase the overall number of participants to 4344. The committee estimated
that the selected sample size would significantly contain the number of LUCAS-2 so that the
quantity of original specified number is maintained. Sample size which was selected did not used
any type of information which was derived from control trial groups. The primary intention was to
provide treatment to all the patients (Wiberg, 2014). The researchers used complier average causal
effect (CACE) analysis so that the effect of cardiac arrest protocol is determined. Logistic
regression models were used in order to provide primary treatment to all the participants in
controlled group or LUCAS-2 group.
Results and Findings
There were no evidence of meta analysis that can provide any inconsistency between the
results of three trials which were conducted in the research (Gässler and et.al, 2015). Further there
were no evidence of improvement in 30 day survival who were directed for LUCAS-2 and manual
chest compression resuscitation procedures. As such there were no critical or adverse reactions
noted but seven severe cases of LUCAS-2 were noted during the procedure. Three participants
among them were reported to suffer from chest bruising whereas two were diagnosed with chest
lacerations. Rest two of them were reported to be notice blood in mouth during the mechanical
compression (Steinberg and et.al, 2016). The results interpreted from the above randomised
controlled trials were also not satisfactory as it was not able to provide any evidence about the
improvement in survival of patients who were subjected to mechanical chest compression through

LUCAS-2.
Discussion and Level of Evidence
In pragmatic cluster randomised trial the introduction of mechanical chest compression did
not prove to increase the survival rate to 30 days (Kugytė and Šliburytė, 2015). When the results of
meta analysis of present research findings were compared with the two previously conducted
randomised controlled trials it was evident that LUCAS-2 mechanical chest compression
resuscitation was not superior in 30 days survival. The trial was conducted to analyse the
effectiveness of mechanical chest compression when implemented in real life settings. Moreover
15% of complexities produced during the research was due to introduction of mechanical CPR as
compared to manual chest compression method (Taylor, Bogdan and DeVault, 2015). In conclusion
the research study failed to prove the effectiveness of mechanical chest compression against manual
technique.

REFERENCES
Books and Journals
Gässler, H. and et.al., 2015. Mechanical chest compression: an alternative in helicopter emergency
medical services?. Internal and emergency medicine. 10(6). pp.715-720.
Kaya, O., Catic, A. and Bergsjo, D., 2014. Exploring the possibilities of using image recognition
technology to create a hybrid lean system for pulse methodology. Procedia Computer Science.
28. pp.275-284.
Kugytė, R. and Šliburytė, L., 2015. A standardized model of service provider selection criteria for
different service types: a consumer-oriented approach. Engineering Economics, 44(4), pp.56-
63.
Perkins, G. D. and et.al., 2015. Mechanical versus manual chest compression for
out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic,
cluster randomised controlled trial. Lancet. 385 .pp- 947–955.
Rothwell, P.M. and et.al., 2012. Short-term effects of daily aspirin on cancer incidence, mortality,
and non-vascular death: analysis of the time course of risks and benefits in 51 randomised
controlled trials. The Lancet. 379(9826). pp.1602-1612.
Steinberg, M.T. and et.al., 2016. Defibrillation success during different phases of the mechanical
chest compression cycle. Resuscitation.
Taylor, S.J., Bogdan, R. and DeVault, M., 2015. Introduction to qualitative research methods: A
guidebook and resource. John Wiley & Sons.
Vasylev, V.N. and et.al., 2013. Methodology experimental and theoretical research efforts in the
assembly pivotally core system using a control system. Metal construction.19(4). pp.215-223.
Wiberg, M., 2014. Methodology for materiality: interaction design research through a material lens.
Personal and Ubiquitous Computing. 18(3). pp.625-636.
Wilfond, B.S. and et.al., 2015. Should We Offer Genomic Research Results to a Participant's
Family, Including After the Participant's Death?: Disclosing Secondary Findings from
Pediatric Sequencing to Families: Considering the" Benefit to Families". JL Med. & Ethics.
43. pp.552-661.