Efficacy of Feed Forward and Feedback Signaling for Inflations and Chest Compression Pressure During Cardiopulmonary Resuscitation in a Newborn Mannequin

Abstract

BackgroundThe objective of the study was to evaluate a device that supports professionals during neonatal cardiopulmonary resuscitation (CPR). The device features a box that generates an audio-prompted rate guidance (feed forward) for inflations and compressions, and a transparent foil that is placed over the chest with marks for inter nipple line and sternum with LED’s incorporated in the foil indicating the exerted force (feedback).MethodsTen pairs (nurse/doctor) performed CPR on a newborn resuscitation mannequin. All pairs initially performed two sessions. Thereafter two sessions were performed in similar way, after randomization in 5 pairs that used the device and 5 pairs that performed CPR without the device (controls). A rhythm score was calculated based on the number of CPR cycles that were performed correctly.ResultsThe rhythm score with the device improved from 85 ± 14 to 99 ± 2% (P < 0.05). In the control group no differences were observed. The recorded pressures with the device increased from 3.1 ± 1.6 to 4.9 ± 0.8 arbitrary units (P < 0.05). The second performance of the teams showed significant better results for the group with the CPR device compared to the controls.ConclusionFeed forward and feedback signaling leads to a more constant rhythm and chest compression pressure during CPR.

Minute ventilation at different compression to ventilation ratios, different ventilation rates, and continuous chest compressions with asynchronous ventilation in a newborn manikin

“…A commonly used duration of CPR cycles in this type of research is 90 seconds or 2 minutes [9,10]. We chose to perform each intervention in series of 10 × 2 minutes.…”

Chest compressions in newborn infants: a scoping review

“…Sixteen studies compared CC feedback devices including 12 manikin studies,69–80 3 animal studies81–83 and 1 clinical study 84. Studies assessed auditory visual feedback devices,69 70 75 78 79 visual feedback alone,71 auditory feed forward devices,72–74 76 77 haptic feedback device80 and real-time physiological feedback using capnography81–83 or blood pressure84 monitoring.…”

“…Sixteen studies compared CC feedback devices including 12 manikin studies,69–80 3 animal studies81–83 and 1 clinical study 84. Studies assessed auditory visual feedback devices,69 70 75 78 79 visual feedback alone,71 auditory feed forward devices,72–74 76 77 haptic feedback device80 and real-time physiological feedback using capnography81–83 or blood pressure84 monitoring. Overall, studies reported a significant improved CC depth,70 79 CC rate,69 70 79 duty cycle69 70 79 and percentage of correctly performed cycles75 when using an auditory-visual feedback device (table 4).…”

A review of approaches to optimise chest compressions in the resuscitation of asphyxiated newborns

“…CPR effectiveness depends on interplay between physiological, mechanical and pedagogical aspects. Real-time feedback systems for CC rate and depth in neonatal CPR are evolving53 54 and may potentially be useful in teaching and training, as well as clinical CPR. Such systems also allow for force-targeted and pressure-targeted rather than depth-targeted CC.…”