Comparison of manual versus mechanical chest compression with ETCO2 value in-hospital cardiac arrest: A prospective observational study

Abstract

Aim: The aim of this study was to compare the effectiveness of manual versus mechanical chest compression by using continuous end-tidal carbon dioxide (ETCO₂) monitoring in-hospital cardiac arrest patients.

Methods: The study included 90 patients meeting the inclusion criteria. Forty-seven (52.2%) patients were male and 43 (47.8%) were female. A prospective observational study of patients who experienced cardiac arrest while being monitored at the emergency department (ED) was conducted at the ED of a tertiary university hospital between April 2018 and September 2019. Demographics, electrocardiography (ECG) rhythm, cardiopulmonary resuscitation (CPR) technique (manual or automatic), laboratory data, the time to return of spontaneous circulation (ROSC), length of stay in the ED, hospitalization, and mortality were compared according to CPR type. Forty-four (48%) patients underwent manual CPR, and 46 (52%) patients underwent automatic CPR.

Results: The 15th-minute and 20th-minute oxygen saturation (SaO₂) levels, and the 10th-, 15th-, and 20th-minute ETCO₂ levels showed a significant difference between the automatic CPR and manual CPR with all three variables being higher in the automatic CPR group (p=0.013, p=0.002, p=0.037, p=0.002, p<0.001, respectively). The causes of cardiopulmonary arrest, consultations, POCUS results, post-CPR lifetime, treatment types and neurological conditions were similar in both of the groups. Exitus was more frequent in the manual CPR device group (p=0,013).

Conclusion: Mechanical Chest Compression provides more high-quality CPR than manual Chest Compression in-hospital cardiac arrest, and mid-resuscitation ETCO₂ values equal to or greater than 20 mmHg appear to be a good predictor of ROSC.

How to cite this article

Yılmaz Y, Yılmaz F, Yılmaz A, Sönmez BM, Tekkanat S, Kavalcı C, Komut S, Beydilli İ, Zortuk Ö. Comparison of manual versus mechanical chest compression with ETCO₂ value in-hospital cardiac arrest:  A prospective observational study. J Med Dent Invest. 2025;6:e250172.