Blewer Audrey L, Putt Mary E, McGovern Shaun K, Murray Andrew D, Leary Marion, Riegel Barbara, Shea Judy A, Berg Robert A, Asch David A, Viera Anthony J, Merchant Raina M, Nadkarni Vinay M, Abella Benjamin S
Department of Family Medicine and Community Health, Duke University, Durham, NC, USA.
Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA, USA.
Resuscitation. 2020 Jul;152:28-35. doi: 10.1016/j.resuscitation.2020.04.026. Epub 2020 May 3.
Since over 80% of sudden cardiac arrests occur in the home, cardiopulmonary resuscitation (CPR) training for family members of high-risk cardiac patients represents a promising intervention. The use of mobile application-based (mApp) CPR training may facilitate this approach, but evidence regarding its efficacy is lacking.
We conducted a multicenter, pragmatic, cluster-randomized trial assessing CPR training for family members of cardiac patients. The interventions were mApp (video, no manikin) and VSI (video + manikin). CPR skills were evaluated 6-months post-training. We hypothesized that chest compression (CC) rate from training with an mApp would be no worse than 5 compressions per minute (CPM) lower compared to VSI.
From 01/2016 to 01/2018, we enrolled 1325 eligible participants (mean age 51.6 years, 68.2% female and 59.4% white). CPR skills were evaluated 6-months post-training in 541 participants (275 VSI, 266 mApp). Mean rate was 84.6 CPM (95% CI: 80.4, 88.6) in VSI, compared to 82.7 CPM (95% CI: 76.2, 89.1) in the mApp, and mean depth was 42.1 mm (95% CI: 40.3, 43.8) in VSI, compared to 38.9 mm (95% CI: 36.2, 41.6) in the mApp. After adjustment, the mean difference in CC rate was -2.3 CPM (95% CI -9.4, 4.8, p = 0.25, non-inferiority) and CC depth was -3.2 mm (95% CI -5.9, 0.1, p = 0.056).
In this large prospective trial of CPR skill retention for family members of cardiac patients, mApp training was associated with lower CC quality. Future work is required to understand additional approaches to improve CPR skill retention.
URL: ClinicalTrials.gov, Identifier: NCT02548793.
由于超过80%的心搏骤停发生在家中，为高危心脏病患者的家庭成员进行心肺复苏（CPR）培训是一种有前景的干预措施。使用基于移动应用程序（mApp）的CPR培训可能有助于实现这种方法，但缺乏关于其有效性的证据。
我们进行了一项多中心、实用、整群随机试验，评估对心脏病患者家庭成员的CPR培训。干预措施为mApp（视频，无人体模型）和VSI（视频 + 人体模型）。在培训后6个月评估CPR技能。我们假设，与VSI相比，使用mApp培训的胸外按压（CC）速率每分钟低不超过5次按压（CPM）。
从2016年1月至2018年1月，我们纳入了1325名符合条件的参与者（平均年龄51.6岁，68.2%为女性，59.4%为白人）。在541名参与者（275名VSI，266名mApp）中于培训后6个月评估CPR技能。VSI组的平均速率为84.6 CPM（95%CI：80.4，88.6），而mApp组为82.7 CPM（95%CI：76.2，89.1）；VSI组的平均深度为42.1毫米（95%CI：40.3，43.8），而mApp组为38.9毫米（95%CI：36.2，41.6）。调整后，CC速率的平均差异为-2.3 CPM（95%CI -9.4，4.8，p = 0.25，非劣效性），CC深度为-3.2毫米（95%CI -5.9，0.1，p = 0.056）。
在这项针对心脏病患者家庭成员CPR技能保持情况的大型前瞻性试验中，mApp培训与较低的CC质量相关。需要开展进一步工作以了解改善CPR技能保持的其他方法。
网址：ClinicalTrials.gov，标识符：NCT02548793。
