Compression-associated injuries using CLOVER3000 device in non-survivor patients of OHCA: A retrospective cohort study

Abstract

Aim: The incidence of compression-associated injuries from using the CLOVER3000, a new mechanical cardiopulmonary resuscitation (CPR) device, is not well studied in the context of out-of-hospital cardiac arrest (OHCA). Thus, we aimed to compare compression-associated injuries between CLOVER3000 and manual CPR.

Methods: This single-center, retrospective, cohort study used data from the medical records of a tertiary care center in Japan between April 2019 and August 2022. We included adult non-survivor patients with non-traumatic OHCA who were transported by emergency medical services and underwent post-mortem computed tomography. Compression-associated injuries were tested using logistic regression models adjusting for age, sex, bystander CPR performance, and CPR duration.

Results: A total of 189 patients (CLOVER3000, 42.3%; manual CPR, 57.7%) were included in the analysis. The overall incidence of compression-associated injuries was similar between the two groups (92.5% vs. 94.54%; adjusted odds ratio (AOR), 0.62 [95% confidence interval (CI), 0.06-1.44]). The most common injury was anterolateral rib fractures with a similar incidence between the two groups (88.7% vs. 88.9%; AOR, 1.03 [95% CI, 0.38 to 2.78]). The second most common injury was sternal fracture in both groups (53.1% vs. 56.7%; AOR, 0.68 [95% CI, 0.36-1.30]). The incidence rates of other injuries were not statistically different between the both groups.

Conclusion: We observed a similar overall incidence of compression-associated injuries between the CLOVER3000 and manual CPR groups on small sample size.

Keywords: Cardiac arrest; Cardiopulmonary resuscitation; Complications; Mechanical chest compressions; Post-mortem computed tomography.