住院心脏骤停患者的实时按压反馈：一项多中心随机对照临床试验。
Real-time compression feedback for patients with in-hospital cardiac arrest: a multi-center randomized controlled clinical trial.
作者信息
Goharani Reza, Vahedian-Azimi Amir, Farzanegan Behrooz, Bashar Farshid R, Hajiesmaeili Mohammadreza, Shojaei Seyedpouzhia, Madani Seyed J, Gohari-Moghaddam Keivan, Hatamian Sevak, Mosavinasab Seyed M M, Khoshfetrat Masoum, Khabiri Khatir Mohammad A, Miller Andrew C
机构信息
1Anesthesiology Research Center, Anesthesia and Critical Care Department, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
出版信息
J Intensive Care. 2019 Jan 22;7:5. doi: 10.1186/s40560-019-0357-5. eCollection 2019.
OBJECTIVE
To determine if real-time compression feedback using a non-automated hand-held device improves patient outcomes from in-hospital cardiac arrest (IHCA).
METHODS
We conducted a prospective, randomized, controlled, parallel study (no crossover) of patients with IHCA in the mixed medical-surgical intensive care units (ICUs) of eight academic hospitals. Patients received either standard manual chest compressions or compressions performed with real-time feedback using the Cardio First Angel™ (CFA) device. The primary outcome was sustained return of spontaneous circulation (ROSC), and secondary outcomes were survival to ICU and hospital discharge.
RESULTS
One thousand four hundred fifty-four subjects were randomized; 900 were included. Sustained ROSC was significantly improved in the CFA group (66.7% vs. 42.4%, < 0.001), as was survival to ICU discharge (59.8% vs. 33.6%) and survival to hospital discharge (54% vs. 28.4%, < 0.001). Outcomes were not affected by intra-group comparisons based on intubation status. ROSC, survival to ICU, and hospital discharge were noted to be improved in inter-group comparisons of non-intubated patients, but not intubated ones.
CONCLUSION
Use of the CFA compression feedback device improved event survival and survival to ICU and hospital discharge.
TRIAL REGISTRATION
The study was registered with Clinicaltrials.gov (NCT02845011), registered retrospectively on July 21, 2016.
目的
确定使用非自动化手持设备的实时按压反馈是否能改善院内心脏骤停（IHCA）患者的预后。
方法
我们在八家学术医院的内科-外科混合重症监护病房（ICU）对IHCA患者进行了一项前瞻性、随机、对照、平行研究（无交叉）。患者接受标准徒手胸外按压或使用Cardio First Angel™（CFA）设备进行实时反馈的按压。主要结局是自主循环恢复（ROSC）持续存在，次要结局是存活至ICU出院和医院出院。
结果
1454名受试者被随机分组；900名被纳入研究。CFA组的ROSC持续存在情况显著改善（66.7%对42.4%，P<0.001），存活至ICU出院的情况也是如此（59.8%对33.6%），存活至医院出院的情况同样如此（54%对28.4%，P<0.001）。结局不受基于插管状态的组内比较影响。在非插管患者的组间比较中，ROSC、存活至ICU和医院出院情况均有改善，但插管患者没有。
结论
使用CFA按压反馈设备改善了事件存活率以及存活至ICU和医院出院的情况。
试验注册
该研究已在Clinicaltrials.gov注册（NCT02845011），于2016年7月21日进行回顾性注册。
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