比较使用反馈设备进行培训或模拟心肺骤停的效果。
Comparison of the effects of using feedback devices for training or simulated cardiopulmonary arrest.
机构信息
Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang, Wuhan, Hubei, 430071, China.
Emergency department, The First People's Hospital of Wuxue, Wuxue, Hubei, 435400, China.
出版信息
J Cardiothorac Surg. 2024 Mar 27;19(1):159. doi: 10.1186/s13019-024-02669-z.
BACKGROUND
High-quality chest compression is essential for successful cardiac arrest resuscitation. High-quality cardiopulmonary resuscitation (CPR) can effectively improve the survival rate of patients with cardiopulmonary arrest. However, bystanders untrained in cardiopulmonary resuscitation may provide inadequate chest compressions. Previous studies have shown that the use of feedback devices in training alone or in simulated cardiopulmonary arrest alone can improve cardiopulmonary resuscitation. This study aims to determine whether using an audiovisual feedback (AVF) device during CPR training or a simulated cardiopulmonary arrest (CA) scenario would be more effective in improving the quality of chest compressions (CC).
METHODS
We use a prospective, randomized, 2 × 2 factorial design trial. A total of 160 participants from Wuhan University and senior clinical medicine undergraduates who had not participated in any CPR training before and had no actual CPR experience are recruited. Each participant is randomized to 1 of 4 permutations, including AVF device vs. no AVF device during CPR training and AVF device vs. no AVF device during simulated CA. Main outcomes and measures are the depth, the percentage of CCs with correct depth (5-6 cm), the rate of CCs, and the percentage of CCs with the correct rate (100-120 cpm).
RESULTS
The use of the AVF device during simulated CA resulted in improved CC quality. In CA without AVF device, the average compression depth and the percentage of adequate depth with AVF device are 5.1 cm, 5.0 cm and 55.5%, 56.3%, respectively, which are higher than those without AVF device (4.5 cm, 4.7 cm and 32.8%, 33.6%). (p = 0.011, p = 0.000, both < 0.05).Compared with CA without AVF device, the average compression rate and the percentage of adequate rate with AVF device are 112.3 cpm, 111.2 cpm and 79.4%, 83.1%, respectively. The average compression rate and the percentage of adequate rate without using the AVF device are 112.4 cpm, 110.3 cpm and 71.5%, 68.5%, respectively. (p = 0.567 > 0.05, p = 0.017 < 0.05)Although the average compression rate in group D is slightly lower than that in group C, the percentage of suitable frequency with the feedback device is still higher than that without AVF device.
CONCLUSION
Using a feedback device during simulated cardiopulmonary arrest is more effective in improving cardiopulmonary resuscitation than during training.
背景
高质量的胸外按压对于成功进行心脏骤停复苏至关重要。高质量的心肺复苏（CPR）可以有效地提高心脏骤停患者的存活率。然而，未经心肺复苏培训的旁观者可能会提供不充分的胸外按压。先前的研究表明，仅在培训中或仅在模拟心脏骤停中使用反馈设备均可改善心肺复苏。本研究旨在确定在 CPR 培训或模拟心脏骤停（CA）期间使用视听反馈（AVF）设备是否更能有效提高胸外按压（CC）的质量。
方法
我们采用前瞻性、随机、2×2 析因设计试验。共招募了来自武汉大学的 160 名参与者和高级临床医学专业的本科生，他们以前没有参加过任何心肺复苏培训，也没有实际的心肺复苏经验。每个参与者随机分为 4 种排列中的 1 种，包括 CPR 培训期间使用 AVF 设备与不使用 AVF 设备以及模拟 CA 期间使用 AVF 设备与不使用 AVF 设备。主要结局和测量指标是深度、正确深度（5-6cm）的 CC 百分比、按压频率和正确频率（100-120cpm）的 CC 百分比。
结果
在模拟 CA 中使用 AVF 设备可提高 CC 质量。在没有 AVF 设备的 CA 中，使用 AVF 设备的平均按压深度和足够深度百分比分别为 5.1cm、5.0cm 和 55.5%、56.3%，高于无 AVF 设备的 4.5cm、4.7cm 和 32.8%、33.6%（p=0.011，p=0.000，均<0.05）。与无 AVF 设备的 CA 相比，使用 AVF 设备的平均按压频率和足够频率百分比分别为 112.3cpm、111.2cpm 和 79.4%、83.1%，而无 AVF 设备的平均按压频率和足够频率百分比分别为 112.4cpm、110.3cpm 和 71.5%、68.5%（p=0.567>0.05，p=0.017<0.05）。尽管 D 组的平均按压频率略低于 C 组，但具有反馈装置的合适频率百分比仍高于无 AVF 设备。
结论
在模拟心脏骤停期间使用反馈设备比在培训期间更有效地改善心肺复苏。
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