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Mechanical Chest Compressions and Simultaneous Defibrillation vs Conventional Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: The LINC Randomized Trial
Study Questions:
Does mechanical chest compression improve outcomes in patients with out-of-hospital cardiac arrest (OHCA)?
Methods:
In this multicenter trial, 2,589 patients (mean age 69.1 years) with OHCA were randomly assigned to mechanical chest compression with defibrillation without a pause in compressions (n = 1,300) or conventional cardiopulmonary resuscitation (CPR, n = 1,289). The primary endpoint was 4-hour survival.
Results:
There was no significant difference in 4-hour survival between the mechanical compression group (23.6%) and the conventional CPR group (23.7%). There also was no significant difference in 6-month survival between the mechanical compression group (8.6%) and conventional CPR group (8.5%).
Conclusions:
The authors concluded that mechanical chest compression in patients with OHCA does not improve outcomes compared to conventional CPR.
Perspective:
Mechanical chest compression has two advantages over manual chest compression: 1) it provides consistently high-quality compressions and is not subject to fatigue or poor technique that can occur during manual compression; and 2) it eliminates the pause in chest compression that occurs during defibrillation in patients undergoing conventional CPR. The failure of mechanical compression to improve outcomes in this study suggests that the quality of manual compression by emergency service personnel is excellent and that the several second pause for defibrillation during conventional CPR is not clinically significant.
Keywords: Cardiology, Cardiopulmonary Resuscitation, Electric Countershock, Heart Arrest, Thorax
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