Automated Devices for Chest Compression: Failure of a Concept

Abstract

External chest compression is the cornerstone of cardiopulmonary resuscitation. The development of automated devices for chest compression was eagerly expected as a tool to improve the prognosis of cardiac arrest that remains catastrophic. The need to limit the interruptions of chest compressions and the very rapid decrease in operator’s performance were strong arguments in favor of automation. Currently available devices are load-distributing chest compression device (Autopulse^®) and a device providing compression by means of a piston (LUCAS^®). Prospective randomized trials that compared them to the manual cardiac massage were all negative. The latest meta-analyzes were even to the detriment of their use regarding the probability of return of spontaneous circulation. The need to pursue cardiopulmonary resuscitation (hypothermia or intoxication) and/or to transport the patient (to extracorporeal membrane oxygenation [ECMO] and non-heart beating donor) pursuing massage are the most obvious indications of the use of automated devices for chest compression in 2016.