CPR quality improvement during in-hospital cardiac arrest using a real-time audiovisual feedback system

Abella, Benjamin S.; Edelson, Dana P.; Kim, Salem; Retzer, Elizabeth; Myklebust, Helge; Barry, Anne M.; O’Hearn, Nicholas; Hoek, Terry L. Vanden; Becker, Lance B.

doi:10.1016/j.resuscitation.2006.10.027

« Previous Next »Resuscitation
Volume 73, Issue 1 , Pages 54-61, April 2007

CPR quality improvement during in-hospital cardiac arrest using a real-time audiovisual feedback system☆

Benjamin S. Abella
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Corresponding author at: Department of Emergency Medicine, Center for Resuscitation Science, University of Pennsylvania, 3400 Spruce Street, Ground Ravdin, Philadelphia, PA 19104, USA. Tel.: +1 215 279 3452; fax: +1 215 662 3953.
Dana P. Edelson
- Section of General Internal Medicine, University of Chicago Hospitals, Chicago, IL 60637, USA
Salem Kim
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
Elizabeth Retzer
- Section of Emergency Medicine, University of Chicago Hospitals, Chicago, IL 60637, USA
Helge Myklebust
- Laerdal Medical Corporation, 4002 Stavanger, Norway
Anne M. Barry
- Section of Emergency Medicine, University of Chicago Hospitals, Chicago, IL 60637, USA
Nicholas O’Hearn
- Department of Critical Care, University of Chicago Hospitals, Chicago, IL 60637, USA
Terry L. Vanden Hoek
- Section of Emergency Medicine, University of Chicago Hospitals, Chicago, IL 60637, USA
Lance B. Becker
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA

Received 1 July 2006; received in revised form 29 September 2006; accepted 2 October 2006.

Summary

Background

Cardiopulmonary resuscitation (CPR) quality during actual cardiac arrest has been found to be deficient in several recent investigations. We hypothesized that real-time feedback during CPR would improve the performance of chest compressions and ventilations during in-hospital cardiac arrest.

Methods

An investigational monitor/defibrillator with CPR-sensing and feedback capabilities was used during in-hospital cardiac arrests from December 2004 to December 2005. Chest compression and ventilation characteristics were recorded and quantified for the first 5min of resuscitation and compared to a baseline cohort of arrest episodes without feedback, from December 2002 to April 2004.

Results

Data from 55 resuscitation episodes in the baseline pre-intervention group were compared to 101 resuscitations in the feedback intervention group. There was a trend toward improvement in the mean values of CPR variables in the feedback group with a statistically significant narrowing of CPR variable distributions including chest compression rate (104±18 to 100±13min⁻¹; test of means, p=0.16; test of variance, p=0.003) and ventilation rate (20±10 to 18±8min⁻¹; test of means, p=0.12; test of variance, p=0.04). There were no statistically significant differences between the groups in either return of spontaneous circulation or survival to hospital discharge.

Conclusions

Real-time CPR-sensing and feedback technology modestly improved the quality of CPR during in-hospital cardiac arrest, and may serve as a useful adjunct for rescuers during resuscitation efforts. However, feedback specifics should be optimized for maximal benefit and additional studies will be required to assess whether gains in CPR quality translate to improvements in survival.

Keywords: Heart arrest, Cardiopulmonary resuscitation, Chest compression, Ventilation