Summary of findings for the main comparison. Continuous chest compression alone compared to interrupted chest compression plus artificial ventilation for out‐of‐hospital cardiac arrest.
| Continuous chest compression alone compared to interrupted chest compression plus artificial ventilation for non asphyxial out‐of‐hospital cardiac arrest | ||||||
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Patient or population: People with non‐trauma related out‐of‐hospital cardiac arrest
Settings: Urban settings in the USA, UK and Sweden (CPR performed by untrained bystanders)
Intervention: Continuous chest compression alone Comparison: Interrupted chest compression plus ventilation | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Interrupted chest compression plus ventilation | Continuous chest compression alone | |||||
| Survival to hospital discharge | 116 per 1000 | 141 per 1000 (117 to 170) | RR 1.21 (1.01 to 1.46) | 3031 (3 studies) | ⊕⊕⊕⊕ High1 | |
| Survival to hospital admission | 341 per 1000 | 402 per 1000 (320 to 504) |
RR 1.18 (0.94 to 1.48) |
520 (1 study) | ⊕⊕⊕⊝ Moderate2 | |
| Survival at one year | See comment | See comment | Not estimable | 0 (0) | See comment | No data available for this outcome |
|
Neurological outcomes at hospital discharge Measured as 'good' or 'moderate' with Cerebral Performance Category classification |
110 per 1000 | 138 per 1000 (103 to 183) |
RR 1.25 (0.94 to 1.66) |
1286 (1 study) | ⊕⊕⊕⊝ Moderate2 | 2/3 sites reported data for this outcome in Rea 2010 |
| Return of spontaneous circulation | See comment | See comment | Not estimable | 0 (0) | See comment | No data available for this outcome |
| Adverse effects | No adverse events were reported | Not estimable | 0 (0) | See comment | No data available for this outcome | |
| Quality of life | See comment | See comment | Not estimable | 0 (0) | See comment | No data available for this outcome |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; CPR: cardiopulmonary resuscitation; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High‐quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate‐quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low‐quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low‐quality: We are very uncertain about the estimate. | ||||||
1 Not downgraded for risk of bias. Although the nature of the studies meant that study personnel, including dispatchers and bystanders would be aware of which mode of cardiopulmonary resuscitation (CPR) was administered, we do not believe that this would have affected survival outcomes. 2 We downgraded one level of the evidence due to imprecision because the total number of events was small.