Effect of the Cardio First Angel™ device on CPR indices: a randomized controlled clinical trial.

Amir Vahedian-Azimi,Seyed J Madani,Andrew C Miller,Hamidreza Jamaati,Morteza Izadi,Ali Amirsavadkouhi,Mohammadreza Hajiesmaeili,Seyed M R Hashemian

doi:10.1186/s13054-016-1296-3

Abstract

BackgroundA number of cardiopulmonary resuscitation (CPR) adjunct devices have been developed to improve the consistency and quality of manual chest compressions. We investigated whether a CPR feedback device would improve CPR quality and consistency, as well as patient survival.MethodsWe conducted a randomized controlled study of patients undergoing CPR for cardiac arrest in the mixed medical-surgical intensive care units of four academic teaching hospitals. Patients were randomized to receive either standard manual CPR or CPR using the Cardio First Angel™ CPR feedback device. Recorded variables included guideline adherence, CPR quality, return of spontaneous circulation (ROSC) rates, and CPR-associated morbidity.ResultsA total of 229 subjects were randomized; 149 were excluded; and 80 were included. Patient demographics were similar. Adherence to published CPR guidelines and CPR quality was significantly improved in the intervention group (p < 0.0001), as were ROSC rates (72 % vs. 35 %; p = 0.001). A significant decrease was observed in rib fractures (57 % vs. 85 %; p = 0.02), but not sternum fractures (5 % vs. 17 %; p = 0.15).ConclusionsUse of the Cardio First Angel™ CPR feedback device improved adherence to published CPR guidelines and CPR quality, and it was associated with increased rates of ROSC. A decrease in rib but not sternum fractures was observed with device use. Further independent prospective validation is warranted to determine if these results are reproducible in other acute care settings.Trial registrationClinicalTrials.gov identifier: NCT02394977. Registered on 5 Mar 2015.

Highlights

A number of cardiopulmonary resuscitation (CPR) adjunct devices have been developed to improve the consistency and quality of manual chest compressions
The non-automated external defibrillator (AED) active compression-passive decompression (ACPD) devices are small, lightweight, Vahedian-Azimi et al Critical Care (2016) 20:147 portable devices that are positioned between the patient and rescuer
Patient population Patients were eligible for study participation if they met the following criteria: (1) age ≥18 years, (2) admitted to the intensive care unit (ICU), (3) full code status, and (4) informed consent was obtained from the patient, legal guardian, or healthcare surrogate upon ICU admission

Summary

Introduction

A number of cardiopulmonary resuscitation (CPR) adjunct devices have been developed to improve the consistency and quality of manual chest compressions. Several devices have been developed to improve the consistency and quality of chest compressions [8, 14, 18, 21] The non-AED ACPD devices are small, lightweight, Vahedian-Azimi et al Critical Care (2016) 20:147 portable devices that are positioned between the patient and rescuer. These devices are positioned on the patient’s chest where the rescuer’s hands would normally be positioned during manual CPR, and compressions are performed on the device. Four non-AED-associated and five AED-associated CPR feedback devices have been tested in clinical and training environments [14]

Methods

Results

Discussion

Conclusion