Citation

Bierens JJLM, Bray J, Abelairas-Gómez C, Barcala-Furelos R, Beerman S, Claesson A, Dunne C, Fukuda T, Jayashree M, T Lagina A, Li L, Mecrow T, Morgan P, Schmidt A, Seesink J, Sempsrott JR, Szpilman D, Thom O, Tobin J, Webber J, Johnson S, Perkins GD. Resusc. Plus 2023; 14: e100406.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.resplu.2023.100406

PMID

37424769

PMCID

PMC10323217

Abstract

OBJECTIVES: The International Liaison Committee on Resuscitation, in collaboration with drowning researchers from around the world, aimed to review the evidence addressing seven key resuscitation interventions: 1) immediate versus delayed resuscitation; (2) compression first versus ventilation first strategy; (3) compression-only CPR versus standard CPR (compressions and ventilations); (4) ventilation with and without equipment; (5) oxygen administration prior to hospital arrival; (6) automated external defibrillation first versus cardiopulmonary resuscitation first strategy; (7) public access defibrillation programmes.

METHODS: The review included studies relating to adults and children who had sustained a cardiac arrest following drowning with control groups and reported patient outcomes. Searches were run from database inception through to April 2023. The following databases were searched Ovid MEDLINE, Pre-Medline, Embase, Cochrane Central Register of Controlled Trials. Risk of bias was assessed using the ROBINS-I tool and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. The findings are reported as a narrative synthesis.

RESULTS: Three studies were included for two of the seven interventions (2,451 patients). No randomised controlled trials were identified. A retrospective observational study reported in-water resuscitation with rescue breaths improved patient outcomes compared to delayed resuscitation on land (n = 46 patients, very low certainty of evidence). The two observational studies (n = 2,405 patients), comparing compression-only with standard resuscitation, reported no difference for most outcomes. A statistically higher rate of survival to hospital discharge was reported for the standard resuscitation group in one of these studies (29.7% versus 18.1%, adjusted odds ratio 1.54 (95% confidence interval 1.01-2.36) (very low certainty of evidence).

CONCLUSION: The key finding of this systematic review is the paucity of evidence, with control groups, to inform treatment guidelines for resuscitation in drowning.

Language: en

Keywords

Drowning; Resuscitation; Cardiac Arrest; International Liaison Committee on Resuscitation