Humans vs. Machines: Mechanical Compression Devices and Their Appropriate Application in the Management of Cardiac Arrest

Purpose of ReviewThis paper reviews the published literature on mechanical compression devices compared to manual compressions to provide clinicians with an overview of the implementation and efficacy.Recent FindingsThe 2020 American Heart Association guidelines now recommend mechanical compression devices under certain circumstances, prompting further discussion of the benefits and risks. Pre-clinical studies have shown marked advantages in organ perfusion and cerebral blood flow with external chest compression provided by mechanical devices when compared to manual compression. However, clinical reports have provided conflicting evidence of benefit, with some studies suggesting harm to those patients receiving mechanical compressions.SummaryThe use of mechanical chest compression devices appears to offer some clinical benefit to victims of cardiac arrest under certain conditions, including prolonged emergency medical services transport, difficult patient extrication, interventional procedures, and organ requisition. Harms include increased rates of solid organ and great vessel injury, thoracic cage fractures, and delays in time to defibrillation. Additional research is needed to evaluate newer devices and their potential integration into modern cardiac arrest care algorithms.