Compression-only or standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of randomized controlled trials

This meta-analysis aims to compare chest compression-only cardiopulmonary resuscitation (CO-CPR) with standard CPR (sCPR), which includes mouth-to-mouth ventilation, as potential strategies for managing out-of-hospital cardiac arrest (OHCA). We systematically searched various databases and registri...

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Main Authors: Arshbeer Singh Sandhu, Muhammad Arslan Arif Maan, Ogechukwu Obi, Oliver Hervir, Mark Abdelnour, Nayan Gandhi, Mansoureh Fatahi, Abuelgasim Mohamed, Ratan Pal Yadav, Jassim Zaheen Shah, Muhammad Ehsan, Wajeeh Ur Rehman
Format: Article
Language:English
Published: PAGEPress Publications 2025-05-01
Series:Monaldi Archives for Chest Disease
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Online Access:https://www.monaldi-archives.org/macd/article/view/3362
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author Arshbeer Singh Sandhu
Muhammad Arslan Arif Maan
Ogechukwu Obi
Oliver Hervir
Mark Abdelnour
Nayan Gandhi
Mansoureh Fatahi
Abuelgasim Mohamed
Ratan Pal Yadav
Jassim Zaheen Shah
Muhammad Ehsan
Wajeeh Ur Rehman
author_facet Arshbeer Singh Sandhu
Muhammad Arslan Arif Maan
Ogechukwu Obi
Oliver Hervir
Mark Abdelnour
Nayan Gandhi
Mansoureh Fatahi
Abuelgasim Mohamed
Ratan Pal Yadav
Jassim Zaheen Shah
Muhammad Ehsan
Wajeeh Ur Rehman
author_sort Arshbeer Singh Sandhu
collection DOAJ
description This meta-analysis aims to compare chest compression-only cardiopulmonary resuscitation (CO-CPR) with standard CPR (sCPR), which includes mouth-to-mouth ventilation, as potential strategies for managing out-of-hospital cardiac arrest (OHCA). We systematically searched various databases and registries such as MEDLINE, Embase, The Cochrane Library, and Clinicaltrials.gov to retrieve relevant studies. We used the revised Cochrane “Risk of Bias” tool for randomized trials (RoB 2.0) to assess the risk of bias in included studies. Revman 5.4 was used to pool dichotomous outcomes under a random effects model. A total of 4 randomized controlled trials were included in our meta-analysis. Our results indicate that CO-CPR was associated with a significantly increased survival to hospital discharge compared to sCPR [relative risk (RR) 1.22, 95% confidence interval (CI): 1.01 to 1.46] with minimal heterogeneity (I2=0%). No significant difference was observed between the two groups regarding 1-day survival (RR 1.07, 95% CI: 0.94 to 1.23), survival to hospital admission with a good neurological outcome (cerebral performance category 1 or 2) (RR 1.10, 95% CI: 0.80 to 1.51), return of spontaneous circulation (RR 1.05, 95% CI: 0.95 to 1.17), and survival to hospital admission (RR 1.08, 95% CI: 0.93 to 1.25). This meta-analysis found that chest CO-CPR significantly improves survival to hospital discharge compared to sCPR for managing OHCA, while yielding comparable results for other resuscitation outcomes.
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spelling doaj-art-b2cd86a7f1bc4ef780535255adab66392025-08-20T03:53:51ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642025-05-0110.4081/monaldi.2025.3362Compression-only or standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of randomized controlled trialsArshbeer Singh Sandhu0Muhammad Arslan Arif Maan1Ogechukwu Obi2https://orcid.org/0000-0003-4184-9644Oliver Hervir3Mark Abdelnour4https://orcid.org/0009-0009-3584-9825Nayan Gandhi5https://orcid.org/0009-0004-8367-6053Mansoureh Fatahi6https://orcid.org/0009-0004-0026-912XAbuelgasim Mohamed7https://orcid.org/0000-0002-2282-9202Ratan Pal Yadav8Jassim Zaheen Shah9https://orcid.org/0009-0004-8210-1282Muhammad Ehsan10Wajeeh Ur Rehman11https://orcid.org/0000-0002-4520-2373Department of Neurosciences, University Hospital Coventry and Warwickshire NHS Trust, Coventry, EnglandDepartment of Medicine, UnityPoint Health, St. Lukes Hospital, Cedar Rapids, IowaNew York Institute of Technology, College of Osteopathic Medicine, New YorkSchool of Medicine, Faculty of Medicine and Health, University of Sydney, CamperdownDepartment of Medicine, University of California Irvine Medical Center, Orange, CaliforniaGCS Medical College Hospital and Research Center, Ahmedabad, GujaratEmergency Department, Shahid Beheshti University of Medical Sciences, TehranFaculty of Medicine, Al Neelain University, KhartoumDepartment of Medicine, NRI Medical College, GunturDepartment of Cardiology, Heart Hospital, DohaDepartment of Medicine, King Edward Medical University, LahoreDepartment of Medicine, United Health Services, Johnson City, New York This meta-analysis aims to compare chest compression-only cardiopulmonary resuscitation (CO-CPR) with standard CPR (sCPR), which includes mouth-to-mouth ventilation, as potential strategies for managing out-of-hospital cardiac arrest (OHCA). We systematically searched various databases and registries such as MEDLINE, Embase, The Cochrane Library, and Clinicaltrials.gov to retrieve relevant studies. We used the revised Cochrane “Risk of Bias” tool for randomized trials (RoB 2.0) to assess the risk of bias in included studies. Revman 5.4 was used to pool dichotomous outcomes under a random effects model. A total of 4 randomized controlled trials were included in our meta-analysis. Our results indicate that CO-CPR was associated with a significantly increased survival to hospital discharge compared to sCPR [relative risk (RR) 1.22, 95% confidence interval (CI): 1.01 to 1.46] with minimal heterogeneity (I2=0%). No significant difference was observed between the two groups regarding 1-day survival (RR 1.07, 95% CI: 0.94 to 1.23), survival to hospital admission with a good neurological outcome (cerebral performance category 1 or 2) (RR 1.10, 95% CI: 0.80 to 1.51), return of spontaneous circulation (RR 1.05, 95% CI: 0.95 to 1.17), and survival to hospital admission (RR 1.08, 95% CI: 0.93 to 1.25). This meta-analysis found that chest CO-CPR significantly improves survival to hospital discharge compared to sCPR for managing OHCA, while yielding comparable results for other resuscitation outcomes. https://www.monaldi-archives.org/macd/article/view/3362CPROHCAcardiac arrestcardiopulmonary resuscitation
spellingShingle Arshbeer Singh Sandhu
Muhammad Arslan Arif Maan
Ogechukwu Obi
Oliver Hervir
Mark Abdelnour
Nayan Gandhi
Mansoureh Fatahi
Abuelgasim Mohamed
Ratan Pal Yadav
Jassim Zaheen Shah
Muhammad Ehsan
Wajeeh Ur Rehman
Compression-only or standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of randomized controlled trials
Monaldi Archives for Chest Disease
CPR
OHCA
cardiac arrest
cardiopulmonary resuscitation
title Compression-only or standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of randomized controlled trials
title_full Compression-only or standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of randomized controlled trials
title_fullStr Compression-only or standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Compression-only or standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of randomized controlled trials
title_short Compression-only or standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of randomized controlled trials
title_sort compression only or standard cardiopulmonary resuscitation for out of hospital cardiac arrest a systematic review and meta analysis of randomized controlled trials
topic CPR
OHCA
cardiac arrest
cardiopulmonary resuscitation
url https://www.monaldi-archives.org/macd/article/view/3362
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