Mechanical chest compressions and gender differences in out-of-hospital-cardiac-arrest

Sammanfattning: Paper I and II. Both early defibrillation and high quality chest compressions are affecting the chances of survival after cardiac arrest (CA). Manual chest compressions delivers only approximately 30% of normal cardiac output and is further deteriorating during transport. Mechanical chest compressions has in experimental studies delivered higher perfusion pressures, cerebral blood flow and end-tidal CO2 compared to manual CPR. Two pilot studies showed no difference in outcome compared to manual CPR. The LINC trial was the first large randomized trial testing the effectiveness and safety of mechanical chest compressions compared to manual CPR. The objectives were to determine whether CPR with mechanical chest compression and defibrillation during ongoing CPR, compared with CPR with manual chest compressions, according to guidelines, would improve 4-hour survival after out-of-hospital cardiac arrest (OHCA).
We could not identify any significant differences in outcome between the two groups.Paper III. Despite women having several adverse characteristics associated with bad outcome after CA, female gender is considered being an independent predictor for early survival. This is however no longer seen after the initial phase, when male survival is significantly higher. The reason for this difference is not known. This has previously been shown in register based studies. This is, to our best knowledge, the first analysis based on a population from a randomized controlled trial. We aimed to identify gender differences in survival after OHCA.
Female gender was an independent predictor for early survival, but this difference was no longer seen at hospital discharge or after 6 months.