Observational studyBMC emergency medicine2025
Effectiveness of mechanical and manual cardiopulmonary resuscitation: evaluation with carotid doppler and metabolic parameters.
Observational study in BMC emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 10. Education and system implementation for enhanced chain of survival.Clinical and experimental emergency medicine · 2026Guideline
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim was to compare the hemodynamic and metabolic effectiveness of manual chest compressions and a mechanical chest compression device during in-hospital cardiac arrest by monitoring carotid Doppler flow and end-tidal carbon dioxide (ETCO₂) and arterial lactate levels.
methodsIn this single-center, prospective, observational cohort study, 54 adult patients with nontraumatic cardiac arrest in the emergency department were enrolled between December 2023 and February 2024. Chest compressions were delivered manually for the first three 2-minute cycles and mechanically for the subsequent two cycles. The peak-systolic velocity (PSV) and end-diastolic velocity (EDV) of the common carotid artery and the ETCO₂ and lactate levels were recorded at cycles 1, 3 and 5. The primary and secondary outcomes were the return of spontaneous circulation (ROSC) and 24-h survival, respectively. The predictive performance of physiological markers was assessed with receiver operating characteristic (ROC) analysis.
resultsROSC was achieved in 41/54 patients (75.9%), and 22/41 patients (53.7%) were alive at 24 h. The ultrasound acquisition time decreased from 39.9 ± 7.2 s in the first (manual) cycle to 25.7 ± 5.5 s in the fifth (mechanical) cycle (p < 0.01). Compared with manual cardiopulmonary resuscitation (CPR), mechanical compression was associated with greater increases in PSV (Δ₃-₅ = 9.0 ± 3.3 cm s⁻¹ vs. Δ₁-₃ = 2.7 ± 2.9 cm s⁻¹; p < 0.01) and EDV, a greater increase in ETCO₂ (3.5 ± 1.7 mm Hg vs. 1.3 ± 1.6 mm Hg; p < 0.01) and a more pronounced decrease in lactate levels (-0.30 ± 0.34 mmol L⁻¹ vs. -0.10 ± 0.19 mmol L⁻¹; p < 0.01). An ETCO₂ value ≥ 35 mm Hg predicted ROSC with 75.6% sensitivity and 53.9% specificity (AUC = 0.70), whereas a lactate level ≤ 5.3 mmol L⁻¹ predicted ROSC with 76.9% sensitivity and 82.9% specificity (AUC = 0.81). Carotid Doppler velocities showed limited discrimination for ROSC (AUC ≈ 0.56-0.58) and should not be used alone for prognostication.
conclusionCompared with the preceding manual cycles, the mechanical cycles were associated with higher carotid flow velocities and more favorable ETCO₂-lactate trajectories; however, given the fixed sequence and co-interventions, causality cannot be inferred.
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