Efficacy and safety of mechanical chest compression compared with manual cardiopulmonary resuscitation in adult non-traumatic cardiac arrest: a systematic review of the literature
Abstract
BACKGROUND: Mechanical chest compression devices deliver consistent compressions, but their clinical benefit over manual cardiopulmonary resuscitation (CPR) and their safety profile remain debated.
OBJECTIVES: To evaluate the effect of mechanical compression compared with manual CPR on survival (primary objective), return of spontaneous circulation (ROSC), neurological outcome, CPR-related injuries, and compression quality in adults with non-traumatic cardiac arrest.
METHODS: A systematic review was conducted according to PRISMA 2020. The search was performed on October 13, 2026, in PubMed, Scopus, and the Cochrane Library. Risk of bias was assessed with the JBI tools and certainty of evidence with the GRADE approach; results were synthesized narratively.
RESULTS: Thirty studies were included: 6 randomized trials, 4 quasi-experimental, 14 cohort, 1 case-control, 4 cross-sectional studies, and 1 case series. In randomized trials, mechanical compression did not improve survival and ROSC (moderate certainty) or neurological outcome (low certainty). Observational studies, exposed to confounding by indication, yielded discordant results (very low certainty). Visceral injuries were more frequent with the devices (very low certainty). In simulations, the devices maintained consistent compressions during transport.
CONCLUSIONS: Mechanical compression is not superior to high-quality manual CPR. Its use appears justified in settings where manual CPR is not practicable or exposes rescuers to risk, within shared protocols and trained teams.
Related
- Active abdominal compression-decompression cardiopulmonary resuscitation versus standard cardiopulmonary resuscitation for adult cardiac arrest: a systematic review and meta-analysis
- Mechanical Cardiopulmonary Resuscitation - Assisted Percutaneous Coronary Intervention during Cardiac Arrest: Feasibility and Outcomes.
- Mechanical ventilation vs bag-valve ventilation during cardiopulmonary resuscitation: a randomized crossover noninferiority trial
- Transport mechanical ventilation during cardiopulmonary resuscitation in out-of-hospital cardiac arrest: an exploratory prehospital pilot study
- ‘Pericardial hyperechoic ring’ on point-of-care ultrasound during cardiopulmonary resuscitation
BibTeX
@article{rizzo2026efficacy,
title = {{Efficacy and safety of mechanical chest compression compared with manual cardiopulmonary resuscitation in adult non-traumatic cardiac arrest: a systematic review of the literature}},
author = {Sara Rizzo and Domitilla Nistri and Mauro Carmine Martucci and Ariangela Poliseno and Nicola Calabrese and Francesco Menolascina},
journal = {Dissertation Nursing},
year = {2026},
month = oct,
doi = {10.54103/dn/32510},
url = {https://doi.org/10.54103/dn/32510},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Efficacy and safety of mechanical chest compression compared with manual cardiopulmonary resuscitation in adult non-traumatic cardiac arrest: a systematic review of the literature
AU - Sara Rizzo
AU - Domitilla Nistri
AU - Mauro Carmine Martucci
AU - Ariangela Poliseno
AU - Nicola Calabrese
AU - Francesco Menolascina
PY - 2026
DA - 2026/10/24
JO - Dissertation Nursing
DO - 10.54103/dn/32510
UR - https://doi.org/10.54103/dn/32510
AB - BACKGROUND: Mechanical chest compression devices deliver consistent compressions, but their clinical benefit over manual cardiopulmonary resuscitation (CPR) and their safety profile remain debated. OBJECTIVES: To evaluate the effect of mechanical compression compared with manual CPR on survival (primary objective), return of spontaneous circulation (ROSC), neurological outcome, CPR-related injuries, and compression quality in adults with non-traumatic cardiac arrest. METHODS: A systematic review was conducted according to PRISMA 2020. The search was performed on October 13, 2026, in PubMed, Scopus, and the Cochrane Library. Risk of bias was assessed with the JBI tools and certainty of evidence with the GRADE approach; results were synthesized narratively. RESULTS: Thirty studies were included: 6 randomized trials, 4 quasi-experimental, 14 cohort, 1 case-control, 4 cross-sectional studies, and 1 case series. In randomized trials, mechanical compression did not improve survival and ROSC (moderate certainty) or neurological outcome (low certainty). Observational studies, exposed to confounding by indication, yielded discordant results (very low certainty). Visceral injuries were more frequent with the devices (very low certainty). In simulations, the devices maintained consistent compressions during transport. CONCLUSIONS: Mechanical compression is not superior to high-quality manual CPR. Its use appears justified in settings where manual CPR is not practicable or exposes rescuers to risk, within shared protocols and trained teams.
SN - 2785-7263
ER -