A mechanical CPR device is an automated machine that delivers chest compressions during cardiac arrest, replacing or augmenting manual CPR. These devices deliver compressions at a consistent rate, depth, and recoil that is difficult to maintain over time with manual CPR, particularly during patient transport or prolonged resuscitation.
Why mechanical CPR devices are used
Manual chest compressions are physically demanding, and compression quality inevitably deteriorates over time as rescuers fatigue. Consistent, high-quality compressions are essential for maintaining blood flow to the brain and other organs during cardiac arrest. Mechanical devices can deliver compressions without fatigue, without interruption for rhythm checks (in most devices), and during situations where manual CPR is impractical or dangerous, such as inside a moving ambulance or during CT scanning.
Common devices
- LUCAS (Lund University Cardiac Assist System): a piston-based device that sits over the patient’s chest and delivers compressions at a fixed rate and depth. It also provides active chest decompression, which may enhance venous return. Widely used by ambulance services in the UK.
- AutoPulse: a load-distributing band device that encircles the chest and delivers compressions through a circumferential squeezing action.
When mechanical CPR is used
Mechanical CPR is used in prolonged resuscitation, during transfer between locations (such as from the scene to hospital), and when manual CPR is not feasible. It is also used to support patients undergoing ECMO (extracorporeal cardiopulmonary resuscitation, ECPR).
Evidence
Large trials comparing mechanical and manual CPR have not shown a consistent survival benefit for mechanical devices when manual CPR is of high quality. Mechanical devices are therefore considered adjuncts in specific situations rather than replacements for skilled manual CPR.
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