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Performing high-quality chest compressions can be challenging in the prehospital environment. To assess whether use of a mechanical chest compression device (LUCAS-2) improves survival, investigators in England randomized 4471 adult patients with nontraumatic out-of-hospital cardiac arrest to receive either mechanical or manual chest compressions. Only 60% of patients randomized to the LUCAS-2 group received mechanical compression.
In an intention-to-treat analysis, the proportions of patients achieving return of spontaneous circulation, survival at 30 days (the primary outcome), and survival at 3 months were similar between groups. The proportion of patients with a favorable neurological outcome was slightly lower in the mechanical compress…