Assessing the Efficacy of Lund University Cardiac Assist System (LUCAS) Mechanical Chest Compression Systems Versus Manual Compression in Cardiac Arrest: A Comprehensive Systematic Review and Meta-Analysis | ||
| Egyptian Journal of Anaesthesia | ||
| Volume 41, Issue 1, 2025, Pages 1-12 PDF (1.01 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egja.2025.370141.1035 | ||
| Authors | ||
| Mohammed Abosamak* 1; Eman Shaban2; Nabil Shallik3; Amira Shaban4; Ahmed Shaban5; Benny Ponappan6; Yavuz Yigit7; Hany Zaki8 | ||
| 1Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine, Tanta University, Egypt. | ||
| 2Cardiology, Al Jufairi Diagnosis and Treatment, MOH, Qatar | ||
| 3Anesthesia, ICU and Perioperative Medicine Department, Hamad Medical Corporation, Doha, Qatar Clinical Anesthesiology Department, Weill Cornell Medical College in Qatar, Doha, Qatar Clinical Anesthesiology Department, College of Medicine | ||
| 4Internal Medicine - Mansoura University Hospital, Egypt. | ||
| 5Internal Medicine - Mansoura General Hospital, Egypt. | ||
| 6Department of Emergency Medicine, Hamad Medical Corporation; Department of Emergency Medicine, College of Medicine, Qatar University, Doha, Qatar. | ||
| 7Hamad Medical Corporation, Department of Emergency Medicine - Doha - Qatar Blizard Institute, Queen Mary University, London, UK | ||
| 8Department of Emergency Medicine, College of Medicine, Qatar University, Doha, Qatar. | ||
| Abstract | ||
| Background Mechanical chest compression devices have gained interest in resuscitation science because they have the capability to continuously provide high-quality CPR and improve outcomes. However, evidence has shown mixed results on their effectiveness. Therefore, the current review was constructed to determine whether the introduction of the Lund University Cardiac Assist System (LUCAS) as a subtype of mechanical CPR can improve the outcomes of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) compared with manual CPR. Methods An extended search for studies relevant to our study was performed on five electronic databases (PubMed, Scopus, ScienceDirect, Medline, and Google Scholar). Quality appraisal of eligible randomized studies was performed using Cochrane’s risk of bias tool, while the Newcastle Ottawa scale was used for the evaluation of observational studies. Moreover, the RevMan software (version.5.4.1) was used to perform all meta-analyses. Results Our extensive search yielded 2409 articles, of which only 18 (7 Randomized controlled trials (RCTs) and 11 observational studies) were eligible for inclusion and analysis. Both RCTs and observational studies have shown that in non-traumatic OHCA patients, pre-hospital CPR with LUCAS was not superior to manual CPR in terms of return to spontaneous circulation (ROSC), survival to hospital admission (SHA), survival to hospital discharge (SHD), and discharge with good neurological outcome. Similarly, in patients with OHCA or IHCA, in-hospital LUCAS mechanical CPR did not demonstrate superiority over manual chest compression, as shown by the ROSC and SHD outcomes. In addition, LUCAS did not improve ROSC and SHD endpoints in patients exhibiting non-shockable rhythms. Furthermore, a subgroup analysis for CPR-related injuries showed that LUCAS mechanical CPR did not pose a significant risk for rib fractures, hemothorax, or pneumothorax compared to manual compression. However, it was associated with an increased risk for sternal injuries as indicated by outcomes in three observational studies. Conclusions In patients with IHCA or OHCA, LUCAS is not more effective than manual compression. Moreover, observational studies suggest that LUCAS might be associated with more sternal fractures. As a result, we are unable to endorse or contradict the adoption LUCAS as first-line intervention for cardiac arrest patients. | ||
| Keywords | ||
| Cardiac arrest; In-hospital cardiac arrest; Lund University Cardiac Assist System; Manual compression; Mechanical chest compression devices; Out-of-hospital cardiac arrest; Systematic Review and Meta-Analysis | ||
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