Vahedian-Azimi Amir, Rahimibashar Farshid, Miller Andrew C
Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Department of Anesthesia and Critical Care, Hamadan University of Medical Sciences, Hamadan, Iran.
Int J Crit Illn Inj Sci. 2020 Jan-Mar;10(1):32-37. doi: 10.4103/IJCIIS.IJCIIS_84_19. Epub 2020 Mar 6.
Strategies that improve cardiopulmonary resuscitation (CPR) guideline adherence may improve in-hospital cardiac arrest (IHCA) outcomes. Real-time audiovisual feedback (AVF) is one strategy identified by the American Heart Association and the International Liaison Committee on Resuscitation as an area needing further investigation. The aim of this study was to determine if in patients with IHCA, does the addition of a free-standing AVF device to standard manual chest compressions during CPR improve sustained return of spontaneous circulation (ROSC) rates (primary outcome) or CPR quality or guideline adherence (secondary outcomes).
This was a prospective, randomized, controlled, parallel study of patients undergoing resuscitation with chest compressions for IHCA in the mixed medical-surgical intensive care units (ICUs) of two academic teaching hospitals. Patients were randomized to receive either standard manual chest compressions or compressions using the Cardio First Angel™ feedback device.
Sixty-seven individuals were randomized, and 22 were included. CPR quality evaluation and guideline adherence scores were improved in the intervention group ( = 0.0005 for both). The incidence of ROSC was similar between groups ( = 0.64), as was survival to ICU discharge ( = 0.088) and survival to hospital discharge ( = 0.095).
The use of the Cardio First Angel™ compression feedback device improved adherence to publish CPR guidelines and CPR quality. The insignificant change in rates of ROSC and survival to ICU or hospital discharge may have been related to small sample size. Further clinical studies comparing AVF devices to standard manual compressions are needed, as are device head-to-head comparisons.
提高心肺复苏（CPR）指南依从性的策略可能会改善院内心脏骤停（IHCA）的结局。实时视听反馈（AVF）是美国心脏协会和国际复苏联合委员会确定的需要进一步研究的领域之一。本研究的目的是确定在IHCA患者中，在心肺复苏期间标准手动胸外按压基础上增加独立的AVF设备是否能提高自主循环恢复（ROSC）的持续率（主要结局）或心肺复苏质量及指南依从性（次要结局）。
这是一项前瞻性、随机、对照、平行研究，研究对象为在两家学术教学医院的综合内科和外科重症监护病房（ICU）接受IHCA胸外按压复苏的患者。患者被随机分为接受标准手动胸外按压或使用Cardio First Angel™反馈设备进行按压两组。
67人被随机分组，22人被纳入研究。干预组的心肺复苏质量评估和指南依从性评分均有所提高（两者均P = 0.0005）。两组之间的ROSC发生率相似（P = 0.64），入住ICU时存活（P = 0.088）及出院时存活（P = 0.095）情况也相似。
使用Cardio First Angel™按压反馈设备可提高对已发布的心肺复苏指南的依从性及心肺复苏质量。ROSC率以及入住ICU或出院时存活率的变化不显著可能与样本量小有关。需要进一步开展将AVF设备与标准手动按压进行比较的临床研究，以及设备之间的直接比较研究。
