TPTh 5.15 Mechanical Versus Manual Cardiopulmonary Resuscitation Causing Traumatic Cardiothoracic and Abdominal Injuries: A Meta-Analysis of Randomised Trials

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ID: 324090
2026
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Abstract
Abstract Background Mechanical cardiopulmonary resuscitation (CPR) devices are increasingly used during cardiac arrest to provide consistent chest compressions; however, concerns persist regarding their potential to cause traumatic injuries compared with manual CPR. Aim To compare the cardiopulmonary and abdominal injuries caused by mechanical versus manual CPR. Methods A meta-analysis was conducted in accordance with PRISMA guidelines. MEDLINE, EMBASE, PubMed, and the Cochrane Library were searched up to October 2025 for RCTs comparing mechanical with manual CPR in adults. Injury outcomes were grouped into clinically relevant categories and analysed using Review Manager 5.4 with a random-effects model. Results Nine RCTs were included. There was no statistically significant difference between mechanical and manual CPR for liver injuries (OR: 1.59, 95% CI: 0.47–5.31, Z = 0.75, P = 0.46), rib and sternal fractures (OR 0.99, 95% CI 0.57–1.71; Z = 0.05, P = 0.96), thoracic or pleural injuries (OR: 1.03, 95% CI: 0.80–1.33, Z = 0.25, P = 0.80), or vascular and haemorrhagic complications (OR: 1.02, 95% CI: 0.20–5.13, Z = 0.02, P = 0.98). Subgroup analysis showed no difference for rib fractures or sternal fractures individually. Mechanical CPR was associated with a higher risk of air embolism (OR: 2.88, 95% CI: 1.27–6.53, Z = 2.54, P = 0.01). Conclusion Mechanical CPR was not associated with increased rates of major injury compared with manual CPR but is associated with a higher risk of air embolism.
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Authors Yahya El-Tahlawy, Mohammad Abir Mamum, Omar Lubbad, Wajeeh Ullah Mahmood, Goldie Khera, Muhammad S Sajid
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.479
URL
https://doi.org/10.1093/bjs/znag087.479
Keywords Keywords not found

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