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

doi:10.1016/j.resuscitation.2019.02.035

Meta-Analysis

. 2019 May:138:82-105.

doi: 10.1016/j.resuscitation.2019.02.035. Epub 2019 Mar 8.

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

Nikolaos Nikolaou¹, Katie N Dainty², Keith Couper³, Peter Morley⁴, Janice Tijssen⁵, Christian Vaillancourt⁶; International Liaison Committee on Resuscitation’s (ILCOR) Basic Life Support and Pediatric Task Forces

Collaborators, Affiliations

Collaborators

International Liaison Committee on Resuscitation’s (ILCOR) Basic Life Support and Pediatric Task Forces:
Theresa Olasveegen, Mary Beth Mancini, Andrew Travers, Bo Løfgren, Chika Nishiyama, David Stanton, Giuseppe Ristagno, Julie Considine, Maaret Castren, Michael Smyth, Peter Kudenchuk, Raffo Escalante, Raul Gazmuri, Steven Brooks, Sung Phil Chung, Tetsuo Hatanaka, Gavin Perkins, Ian Maconachie, Richard Aickin, Allan De Caen, Dianne Atkins, Robert Bingham, Thomaz Bittencourt Couto, Anne-Marie Guerguerian, Peter Meaney, Vinay Nadkarni, Kee-Chong Ng, Gabrielle Nuthall, Yong-Kwang Gene Ong, Amelia Reis, Steve Schexnayder, Naoki Shimizu, Patrick Van de Voorde

Affiliations

¹ Department of Cardiology and Cardiac Intensive Care, Konstantopouleio General Hospital, Agias Olgas 3-5, Nea Ionia, Athens, 142 33, Greece. Electronic address: nikosnik@otenet.gr.
² Office of Research & Innovation, North York General Hospital, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. Electronic address: katie.dainty@utoronto.ca.
³ Warwick Medical School, University of Warwick, Coventry, UK; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
⁴ Royal Melbourne Hospital Clinical School, The University of Melbourne, Melbourne, Australia.
⁵ Department of Pediatrics, Schulich School of Medicine & Dentistry, Western University, London, Canada; Pediatric Intensive Care Unit, London Health Sciences Centre, London, ON, Canada.
⁶ Department of Emergency Medicine, University of Ottawa and Clinical Epidemiology Program, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.

PMID: 30853623
DOI: 10.1016/j.resuscitation.2019.02.035

Meta-Analysis

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

Nikolaos Nikolaou et al. Resuscitation. 2019 May.

. 2019 May:138:82-105.

doi: 10.1016/j.resuscitation.2019.02.035. Epub 2019 Mar 8.

Authors

Collaborators

International Liaison Committee on Resuscitation’s (ILCOR) Basic Life Support and Pediatric Task Forces:
Theresa Olasveegen, Mary Beth Mancini, Andrew Travers, Bo Løfgren, Chika Nishiyama, David Stanton, Giuseppe Ristagno, Julie Considine, Maaret Castren, Michael Smyth, Peter Kudenchuk, Raffo Escalante, Raul Gazmuri, Steven Brooks, Sung Phil Chung, Tetsuo Hatanaka, Gavin Perkins, Ian Maconachie, Richard Aickin, Allan De Caen, Dianne Atkins, Robert Bingham, Thomaz Bittencourt Couto, Anne-Marie Guerguerian, Peter Meaney, Vinay Nadkarni, Kee-Chong Ng, Gabrielle Nuthall, Yong-Kwang Gene Ong, Amelia Reis, Steve Schexnayder, Naoki Shimizu, Patrick Van de Voorde

Affiliations

¹ Department of Cardiology and Cardiac Intensive Care, Konstantopouleio General Hospital, Agias Olgas 3-5, Nea Ionia, Athens, 142 33, Greece. Electronic address: nikosnik@otenet.gr.
² Office of Research & Innovation, North York General Hospital, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. Electronic address: katie.dainty@utoronto.ca.
³ Warwick Medical School, University of Warwick, Coventry, UK; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
⁴ Royal Melbourne Hospital Clinical School, The University of Melbourne, Melbourne, Australia.
⁵ Department of Pediatrics, Schulich School of Medicine & Dentistry, Western University, London, Canada; Pediatric Intensive Care Unit, London Health Sciences Centre, London, ON, Canada.
⁶ Department of Emergency Medicine, University of Ottawa and Clinical Epidemiology Program, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.

PMID: 30853623
DOI: 10.1016/j.resuscitation.2019.02.035

Abstract

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.

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

Collaborators

Affiliations

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

Authors

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Abstract

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