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| Superiority of cardiopulmonary resuscitation plus automated external defibrillator used by first-responders on patients with out-of-hospital cardiac arrests: a meta-analysis |
| Zhao Peng-cheng, Bi Chao, Jiang Ting, Wang Wei-wei, Li Chun-yu, Chen Jun, Deng Bo, Wu Piao-nv, Zhang Jin-song, Cao Ke-jiang, Chen Yan |
| Emergency Medical Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China |
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Abstract Objective To perform a meta-analysis of the pooled effect of the included studies comparing the outcome of the patients receiving cardiopulmonary resuscitation(CPR)plus automated external defibrillator (AED) therapy (CPR+AED)vs.CPR alone(CPR-Only),both delivered by first-responders who witness the out-of-hospital cardiac arrest(OHCA) before the emergency medical service(EMS) arrives. Methods We performed a search of the relevant literature exploring major scientific databases. We assessed the quality of the included cohort study according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Three analyses were planned to assess the outcomes of interest (survival to hospital admission; survival to hospital discharge and return of spontaneous circulation). Data were elaborated with the software Revman5.3. Results Ten studies(9748 patients)were selected for the meta-analysis. The meta-analysis evidenced a statistical difference between the CPR+AED and the CPR-Only in survival to hospital discharge (RR=1.48, 95%CI 1.35～1.63,P＜0.00001).The analysis also showed a statistical difference between CPR+AED and CPR-Only in survival to hospital admission (RR=1.24, 95%CI 1.12～1.37,P＜0.0001). However,there was no significant difference between the two groups in return of spontaneous circulation(ROSC) (RR=1.09，95%CI 1.00～1.19, P=0.05). Conclusion The results of our meta-analysis demonstrate that CPR plus early defibrillation with AEDs by first-responders offers a survival advantage over CPR alone or CPR with defibrillation by the EMS in OHCA.
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Corresponding Authors:
Chen Yan, E-mail: chenyandoc@163.com
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