Mechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm: a randomised controlled feasibility trial (COMPRESS-RCT)

Keith Couper, Tom Quinn, Ranjit Lall, Anne Devrell, Barry Orriss, Kate Seers, Joyce Yeung, Gavin D Perkins, COMPRESS-RCT collaborators, Catherine Baldock, Christopher Bassford, Roger Beadle, Sukhdeep Dosanjh, Anthony Freestone, Jonathan Hulme, Catherine Lawrence, Keith Couper, Tom Quinn, Ranjit Lall, Anne Devrell, Barry Orriss, Kate Seers, Joyce Yeung, Gavin D Perkins, COMPRESS-RCT collaborators, Catherine Baldock, Christopher Bassford, Roger Beadle, Sukhdeep Dosanjh, Anthony Freestone, Jonathan Hulme, Catherine Lawrence

Abstract

Background: Mechanical chest compression devices consistently deliver high-quality chest compressions. Small very low-quality studies suggest mechanical devices may be effective as an alternative to manual chest compressions in the treatment of adult in-hospital cardiac arrest patients. The aim of this feasibility trial is to assess the feasibility of conducting an effectiveness trial in this patient population.

Methods: COMPRESS-RCT is a multi-centre parallel group feasibility randomised controlled trial, designed to assess the feasibility of undertaking an effectiveness to compare the effect of mechanical chest compressions with manual chest compressions on 30-day survival following in-hospital cardiac arrest. Over approximately two years, 330 adult patients who sustain an in-hospital cardiac arrest and are in a non-shockable rhythm will be randomised in a 3:1 ratio to receive ongoing treatment with a mechanical chest compression device (LUCAS 2/3, Jolife AB/Stryker, Lund, Sweden) or continued manual chest compressions. It is intended that recruitment will occur on a 24/7 basis by the clinical cardiac arrest team. The primary study outcome is the proportion of eligible participants randomised in the study during site operational recruitment hours. Participants will be enrolled using a model of deferred consent, with consent for follow-up sought from patients or their consultee in those that survive the cardiac arrest event. The trial will have an embedded qualitative study, in which we will conduct semi-structured interviews with hospital staff to explore facilitators and barriers to study recruitment.

Discussion: The findings of COMPRESS-RCT will provide important information about the deliverability of an effectiveness trial to evaluate the effect on 30-day mortality of routine use of mechanical chest compression devices in adult in-hospital cardiac arrest patients.

Trial registration: ISRCTN38139840 , date of registration 9th January 2017.

Keywords: Advanced cardiac life support; Cardiac arrest; Cardiopulmonary resuscitation; Mechanical chest compression device.

Conflict of interest statement

Ethics approval and consent to participate

The trial was approved by the West Midlands - Coventry & Warwickshire Research Ethics Committee, who waived the requirement to seek consent from patient participants prior to enrolment.

Consent for publication

Not applicable

Competing interests

TQ, RL, and GDP were investigators on the PARAMEDIC trial, which was an NIHR funded trial that evaluated the use of mechanical chest compression devices in the pre-hospital setting. The remaining authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Trial flow diagram

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