虚拟现实复苏培训中胸外按压深度和频率的最佳组合:随机低地拯救生命试验的事后分析。

Optimal Combination of Chest Compression Depth and Rate in Virtual Reality Resuscitation Training: A Post Hoc Analysis of the Randomized Lowlands Saves Lives Trial.

机构信息

Department of Cardiology Radboud University Medical Center Nijmegen the Netherlands.

出版信息

J Am Heart Assoc. 2021 Jan 19;10(2):e017367. doi: 10.1161/JAHA.120.017367. Epub 2021 Jan 14.

Abstract

Background Dissemination of cardiopulmonary resuscitation (CPR) skills is essential for cardiac arrest survival. Virtual reality (VR)-training methods are low cost and easily available, but to meet depth requirements adaptations are required, as confirmed in a recent randomized study on currently prevailing CPR quality criteria. Recently, the promising clinical performance of new CPR quality criteria was demonstrated, based on the optimal combination of compression depth and rate. We now study compliance with these newly proposed CPR quality criteria. Methods and Results Post hoc analysis of a randomized trial compared standardized 20-minute face-to-face CPR training with VR training using the Lifesaver VR smartphone application. During a posttraining test, compression depth and rate were measured using CPR mannequins. We assessed compliance with the newly proposed CPR criteria, that is, compression rate within ±20% of 107/minute and depth within ±20% of 47 mm. We studied 352 participants, age 26 (22-31) years, 56% female, and 15% with CPR training ≤2 years. Among VR-trained participants, there was a statistically significant difference between the proportions complying with newly proposed versus the currently prevailing quality criteria (52% versus 23%, <0.001). The difference in proportions complying with rate requirements was statistically significant (96% for the new versus 50% for current criteria, <0.001), whereas there was no significant difference with regard to the depth requirements (55% versus 51%, =0.45). Conclusions Lifesaver VR training, although previously found to be inferior to face-to-face training, may lead to CPR quality compliant with recently proposed, new quality criteria. If the prognostic importance of these new criteria is confirmed in additional studies, Lifesaver VR in its current form would be an easily available vector to disseminate CPR skills.

摘要

背景 心肺复苏(CPR)技能的传播对于心脏骤停的存活至关重要。虚拟现实(VR)培训方法成本低且易于获得,但为了满足深度要求,需要进行适应性调整,这在最近一项关于当前流行的 CPR 质量标准的随机研究中得到了证实。最近,新的 CPR 质量标准的临床性能表现令人鼓舞,这是基于压缩深度和频率的最佳组合。我们现在研究这些新提出的 CPR 质量标准的符合情况。

方法和结果 一项随机试验的事后分析比较了使用 Lifesaver VR 智能手机应用程序的标准化 20 分钟面对面 CPR 培训与 VR 培训。在培训后的测试中,使用 CPR 模型测量压缩深度和频率。我们评估了对新提出的 CPR 标准的遵守情况,即压缩频率在±107 次/分钟的 20%范围内,深度在±47mm 的 20%范围内。我们研究了 352 名参与者,年龄 26 岁(22-31 岁),女性占 56%,CPR 培训≤2 年的占 15%。在接受 VR 培训的参与者中,新提出的与当前流行的质量标准相比,符合新提出的质量标准的比例存在统计学显著差异(52%对 23%,<0.001)。在符合频率要求的比例方面存在统计学显著差异(新的 96%与当前标准的 50%,<0.001),而在深度要求方面没有显著差异(55%对 51%,=0.45)。

结论 Lifesaver VR 培训虽然之前被发现不如面对面培训,但可能会导致 CPR 质量符合最近提出的新标准。如果这些新标准的预后重要性在其他研究中得到证实,那么当前形式的 Lifesaver VR 将是一种易于获得的传播 CPR 技能的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8acf/7955309/b53c6854847e/JAH3-10-e017367-g001.jpg

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