A systematic review and meta-analysis of the effect of dispatcher-assisted CPR on outcomes from sudden cardiac arrest in adults and children

International Liaison Committee on Resuscitation's (ILCOR) Basic Life Support and Pediatric Task Forces

Résultat de recherche: Review articleexamen par les pairs

83 Citations (Scopus)

Résumé

Background: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) has been reported in individual studies to significantly increase the rate of bystander CPR and survival from cardiac arrest. Methods: We undertook a systematic review and meta-analysis to evaluate the impact of DA-CPR programs on key clinical outcomes following out-of-hospital cardiac arrest. We searched the PubMED, EMBASE, CINAHL, ERIC and Cochrane Central Register of Controlled Trials databases from inception until July 2018. Eligible studies compared systems with and without dispatcher-assisted CPR programs. The results of included studies were classified into 3 categories for the purposes of more accurate analysis: comparison of outcomes in systems with DA-CPR programs, case-based comparison of DA-CPR to bystander CPR, and case-based comparisons of DA-CPR to no CPR before EMS arrival. The GRADE system was used to assess certainty of evidence at an outcome level. We used random-effects models to produce summary effect sizes across all outcomes. Results: Of 5531 citations screened, 33 studies were eligible for inclusion. All included studies were observational. Evidence certainty across all outcomes was assessed as low or very low. In system-level and patient-level comparisons, the provision of DA-CPR compared with no DA-CPR was consistently associated with improved outcome across all analyses. Comparison of DA-CPR to bystander CPR produced conflicting results. Findings were consistent across sensitivity analyses and the pediatric sub-group. Conclusion: These results support the recommendation that dispatchers provide CPR instructions to callers for adults and children with suspected OHCA. Review registration: PROSPERO- CRD42018091427.

Langue d'origineEnglish
Pages (de-à)82-105
Nombre de pages24
JournalResuscitation
Volume138
DOI
Statut de publicationPublished - mai 2019

Note bibliographique

Funding Information:
This Systematic Review was funded by the American Heart Association, on behalf of The International Liaison Committee on Resuscitation (ILCOR). The following authors received payment from this funding source to complete this systematic review: Nikolaos Nikolaou as Expert Systematic Reviewer and David Lightfoot as Information Services, St Michael's HospitalCV has received peer-reviewed funding to study the topic of Dispatcher-Assisted CPR from the Canadian Institutes of Health Research, Heart & Stroke Foundation of Canada and the Cardiac Arrhythmia Network of Canada (CANet). Besides the author Christian Vaillancourt (BLS) and Janice Tijssen (PLS), the members of the International Liaison Committee on Resuscitation Basic Life Support (BLS) Task Force and Pediatric Life Support (PLS) Task Force include:

Publisher Copyright:
© 2019 Elsevier B.V.

ASJC Scopus Subject Areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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