TY - JOUR
T1 - Effects of real-time feedback on cardiopulmonary resuscitation quality on outcomes in adult patients with cardiac arrest
T2 - A systematic review and meta-analysis
AU - Wang, Shao An
AU - Su, Chan Ping
AU - Fan, Hsien Yu
AU - Hou, Wen Hsuan
AU - Chen, Yang Ching
N1 - Copyright © 2020 Elsevier B.V. All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - AIM: To investigate the relationship between the implementation of real-time audiovisual cardiopulmonary resuscitation (CPR) feedback devices with cardiac arrest patient outcomes, such as return of spontaneous circulation (ROSC), short-term survival, and neurological outcome.METHODS: We systematically searched PubMed, Embase, and the Cochrane CENTRAL from inception date until April 30, 2020, for eligible randomized and nonrandomized studies. Pooled odds ratio (OR) for each binary outcome was calculated using R system. The primary patient outcome was ROSC. The secondary outcomes were short-term survival and favorable neurological outcomes (cerebral performance category scores: 1 or 2).RESULTS: We identified 11 studies (8 nonrandomized and 3 randomized studies) including 4851 patients. Seven studies documented patients with out-of-hospital cardiac arrest and four studies documented patients with in-hospital cardiac arrest. The pooled results did not confirm the effectiveness of CPR feedback device, possibly because of the high heterogeneity in ROSC (OR: 1.42, 95% CI: 1.03-1.94, I
2: 80%, tau
2: 0.1875, heterogeneity test p < 0.01) and survival-to-discharge (OR: 1.27, 95% CI: 0.74-2.18, I
2: 86%, tau
2: 0.4048, heterogeneity test p < 0.01). The subgroup analysis results revealed that heterogeneity was due to the types of devices used. Patient outcomes were more favorable in studies investigating portable devices than in studies investigating automated external defibrillator (AED)-associated devices.
CONCLUSIONS: Whether real-time CPR feedback devices can improve patient outcomes (ROSC and short-term survival) depend on the type of device used. Portable devices led to better outcomes than did AED-associated devices. Future studies comparing different types of devices are required to reach robust conclusion.PROTOCOL REGISTRATION: Prospero registration ID CRD42020155388.
AB - AIM: To investigate the relationship between the implementation of real-time audiovisual cardiopulmonary resuscitation (CPR) feedback devices with cardiac arrest patient outcomes, such as return of spontaneous circulation (ROSC), short-term survival, and neurological outcome.METHODS: We systematically searched PubMed, Embase, and the Cochrane CENTRAL from inception date until April 30, 2020, for eligible randomized and nonrandomized studies. Pooled odds ratio (OR) for each binary outcome was calculated using R system. The primary patient outcome was ROSC. The secondary outcomes were short-term survival and favorable neurological outcomes (cerebral performance category scores: 1 or 2).RESULTS: We identified 11 studies (8 nonrandomized and 3 randomized studies) including 4851 patients. Seven studies documented patients with out-of-hospital cardiac arrest and four studies documented patients with in-hospital cardiac arrest. The pooled results did not confirm the effectiveness of CPR feedback device, possibly because of the high heterogeneity in ROSC (OR: 1.42, 95% CI: 1.03-1.94, I
2: 80%, tau
2: 0.1875, heterogeneity test p < 0.01) and survival-to-discharge (OR: 1.27, 95% CI: 0.74-2.18, I
2: 86%, tau
2: 0.4048, heterogeneity test p < 0.01). The subgroup analysis results revealed that heterogeneity was due to the types of devices used. Patient outcomes were more favorable in studies investigating portable devices than in studies investigating automated external defibrillator (AED)-associated devices.
CONCLUSIONS: Whether real-time CPR feedback devices can improve patient outcomes (ROSC and short-term survival) depend on the type of device used. Portable devices led to better outcomes than did AED-associated devices. Future studies comparing different types of devices are required to reach robust conclusion.PROTOCOL REGISTRATION: Prospero registration ID CRD42020155388.
KW - Cardiopulmonary resuscitation
KW - Feedback
KW - Real-time
KW - Return of spontaneous circulation
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85089364042&partnerID=8YFLogxK
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U2 - 10.1016/j.resuscitation.2020.07.024
DO - 10.1016/j.resuscitation.2020.07.024
M3 - Review article
C2 - 32755666
AN - SCOPUS:85089364042
SN - 0300-9572
VL - 155
SP - 82
EP - 90
JO - Resuscitation
JF - Resuscitation
ER -