Acute cardiac care & resuscitation

The association of mechanical versus manual chest compressions with neurological outcomes at hospital discharge among out-of-hospital cardiac arrests treated with intra-arrest transport

ResuscitationPublished Registry study using the British Columbia Cardiac Arrest Registry

Authors' conclusion

Among cases treated with IAT, we did not detect an association between MCC, compared to manual chest compressions, and favorable neurological outcome at hospital discharge.

Study context

Population
Adult non-traumatic out-of-hospital cardiac arrest (out-of-hospital cardiac arrests (OHCA)) cases (January 2019 - June 2025) transported to hospital with ongoing chest compressions (intra-arrest transport, intra-arrest transport (IAT))cases treated with IAT · of whom received mechanical chest compression (MCC) 243 (12%) · of whom received manual chest compressions 1,724 (84%)
Participants
1,967 participants
Exposure
MCC versus manual chest compressions
  • MCCn = 243
  • Manual chest compressionsn = 1,724reference
Outcome
ROSC at hospital arrival
Follow-up
Hospital arrival
Methodological detailsadjusted logistic regression model
  • Adjusted logistic regression model

Main finding

As reported in the abstract

Observational data: associations, not effects.

Further findings

Survival to hospital discharge

OutcomeMCCManual chest compressionsAOR (95% CI)
Favorable neurological outcome (Cerebral Performance Category 1-2) · hospital dischargeNo association detected · adjusted logistic regression6.6%7.1%0.93 (0.51–1.69)

Baseline characteristics

Patient and cardiac arrest characteristics between groups were similar, including presence of bystander CPR and any period of on-scene return of spontaneous circulation (ROSC)

Original publication

The association of mechanical versus manual chest compressions with neurological outcomes at hospital discharge among out-of-hospital cardiac arrests treated with intra-arrest transport. Resuscitation. Published 19 February 2026. doi:10.1016/j.resuscitation.2026.111020

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