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

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.

Use of a Real-Time Training Software (Laerdal QCPR®) Compared to Instructor-Based Feedback for High-Quality Chest Compressions Acquisition in Secondary School Students: A Randomized Trial

“…Indeed, adequate rate and depth have been associated with better blood flow and oxygen delivery to the heart and brain and with an increased rate of return of spontaneous circulation (ROSC) and neurologically intact survival-to-hospital discharge. Incomplete chest recoil has been associated with reduced venous return to the heart and consequently reduced mean arterial pressure and coronary and cerebral perfusion pressures [5,9,10] Recently, a number of real-time automated feedback devices have been introduced in order to enhance both training and performance of CPR [11–13]. They generally provide a feedback based on direct assessment of current parameters of CPR and their real-time visualization through a software interface.…”

Effect of a feedback system on the quality of 2-minute chest compression-only cardiopulmonary resuscitation: a randomised crossover simulation study

“…Feedback devices can track compression metrics in real time as a means of evaluating the CC quality in real CPR or CPR training courses; moreover, they can help to close the gap between current CPR metrics and established guidelines and increase the likelihood of high-quality CPR in terms of minimal interruptions and no-flow time. [7][8][9][10][11][12][13][14][15][16][17][18] Although the positive effects of audiovisual feedback during CPR or CPR training have already been confirmed by numerous studies, the results remain controversial because of differences in the individual participants, research designs, outcome metrics, or CC criteria. [7][8][9][10][11][12][13][14][15][16][17][18] In this study, we investigated the quality of 2-minute CCCs performed by healthcare professionals according to the 2015 AHA guidelines.…”

A comparison of commercially available compression feedback devices in novice and experienced healthcare practitioners: A prospective randomized simulation study

“…Non‐AED devices require active chest compression, and most utilize passive decompression (ACPD). The associated technology ranges in complexity from a simple metronome to electromagnetic sensing (Fischer, Gruber, et al, ; Fischer, Neuhold, et al, ; Kovic, Lulic, & Lulic, ; Segal, Laurent, Maman, Plaisance, & Augustin, ; Truszewski et al, ; Vahedian‐Azimi et al, ; Yeung, Davies, Gao, & Perkins, ). Some devices are designed for use by both medical personnel and laypersons (Buléon et al, ; Papalexopoulou et al, ; Skorning et al, ; Yeung et al, ; Zapletal et al, ).…”

“…A ninth device, the CPR RsQ Assist® (CPR RsQ Assist Inc., Naples, FL, USA) is commercially available without published studies. The Cardio First Angel (CFA; Inotech Gruppe, Neuberg, Germany) is the only device with published clinical trials (Vahedian-Azimi et al, 2016). In a randomized trial of patients with in-hospital cardiac arrest (IHCA; n = 900), significant improvements in sustained ROSC and survival to ICU and hospital discharge were observed for patients receiving compressions using the CFA device compared to standard compressions [unpublished data].…”