Cochrane does it’s usual thing. Looks at available evidence, then concludes more evidence is needed, and that the use of mechanical CPR isn’t supported by this Cochrane review. The problem is that they’re missing the point of mechanical compression devices.
Running to stand-still
We have written before in CPR: Man vs Machine: 1-1: Mechanical Compression Devices are not for better compressions – they’re for logistics. Facilitating transport, freeing up hands, making the patient less crowded, facilitating angio/PCI on arrested patient and so on. THAT is where LUCAS and friends come into play.
So for this, the comparison should be between LUCAS and bad – or even abscent – manual compressions in the back of an ambulance racing through the streets. LUCAS will win this match.
It is also important to have good data that Mechanical Compression devices are working properly, are reliable and don’t cause harm – and in our opinion, we’ve got good enough evidence for that now. There is no point in adding MCDs to try to improve the manual compression show. It would be great if MCDs were better than manual CPR, but it might just be that we’re already at the limit of efficiency from closed chest compressions. This might be as good as it gets.
The way forward
Most cardiac arrests are solved the old fashioned way – and should be. To step it up, open chest cardiac compressions might be the answer – or even better: hooking selected non-responders up to ECMO in ED.
Mechanical compression devices aren’t for every arrest. But Cochrane or no Cochrane support, for transport and other logistical challenges, LUCAS and friends can still be good friends to have.