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Real-Time Compression Feedback for Patients With In-Hospital Cardiac Arrest: A Multi-Center Randomized Controlled Clinical Trial Publisher



Goharani R1 ; Vahedianazimi A2 ; Farzanegan B3 ; Bashar FR4 ; Hajiesmaeili M1 ; Shojaei S1 ; Madani SJ5 ; Goharimoghaddam K6 ; Hatamian S7 ; Mosavinasab SMM8 ; Khoshfetrat M9 ; Khabiri Khatir MA10 ; Miller AC11
Authors
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Authors Affiliations
  1. 1. Anesthesiology Research Center, Anesthesia and Critical Care Department, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
  3. 3. Tracheal Diseases Research Center, Anesthesia and Critical Care Department, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Anesthesia and Critical Care Department, Hamedan University of Medical Sciences, Hamedan, Iran
  5. 5. Medicine Faculty, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
  6. 6. Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Anesthesia and Critical Care Department, Alborz University of Medical Sciences, Karaj, Iran
  8. 8. Anesthesiology Research Center, Anesthesia Care Department, Modares Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  9. 9. Anesthesiology Research Center, Anesthesia and Critical Care Department, Khatam-o-anbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
  10. 10. Anesthesiology Research Center, Anesthesia and Critical Care Department, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  11. 11. Department of Emergency Medicine, Vident Medical Center, East Carolina University Brody School of Medicine, 600 Moye Blvd, Greenville, 27834, NC, United States

Source: Journal of Intensive Care Published:2019


Abstract

Objective: To determine if real-time compression feedback using a non-automated hand-held device improves patient outcomes from in-hospital cardiac arrest (IHCA). Methods: We conducted a prospective, randomized, controlled, parallel study (no crossover) of patients with IHCA in the mixed medical-surgical intensive care units (ICUs) of eight academic hospitals. Patients received either standard manual chest compressions or compressions performed with real-time feedback using the Cardio First Angel™ (CFA) device. The primary outcome was sustained return of spontaneous circulation (ROSC), and secondary outcomes were survival to ICU and hospital discharge. Results: One thousand four hundred fifty-four subjects were randomized; 900 were included. Sustained ROSC was significantly improved in the CFA group (66.7% vs. 42.4%, P < 0.001), as was survival to ICU discharge (59.8% vs. 33.6%) and survival to hospital discharge (54% vs. 28.4%, P < 0.001). Outcomes were not affected by intra-group comparisons based on intubation status. ROSC, survival to ICU, and hospital discharge were noted to be improved in inter-group comparisons of non-intubated patients, but not intubated ones. Conclusion: Use of the CFA compression feedback device improved event survival and survival to ICU and hospital discharge. © 2019 The Author(s).
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