Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: A prospective interventional study
Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: A prospective interventional study
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DOI：
10.1016/j.resuscitation.2006.05.011
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发表时间：
2006-12-01
期刊：
影响因子：
6.5
通讯作者：
Steen, Petter Andreas
中科院分区：
文献类型：
--
作者：
Kramer-Johansen, Jo;Myklebust, Helge;Steen, Petter Andreas
目的：比较质量CPR在院外心脏骤停与无自动feedback.Materials和方法：连续性成人，院外心脏骤停的所有原因进行了研究。176次（2002年3月至2003年10月）没有反馈的事件与108次（2003年10月至2004年9月）自动反馈CPR的事件进行了比较。自动化的口头和视觉反馈是基于原型除颤器的测量质量。CPR的质量是主要的结果指标，生存率按照方案中的规定进行报告。34 9至38 +/-6 mm（平均差异（95% CI）4（2，6），P < 0.001），适当深度（38-51 mm）的按压百分比中位数从24%增加到53%（P < 0.001，Mann-Whitney U检验）。平均压迫率从121 +/- 18降至109 +/- 12 min（-1）（差异-12（-16，-9），P=0.001）。平均每分钟通气次数无变化; 11 +/- 5 min（-1）vs 11 +/- 4 min（-1）（差值0（-1，1），P=0.8）或无胸外按压的时间分数; 0.48 +/- 0.18对比0.45 +/- 0.17（差异-0.03（-0.08，0.01），P=0.08）。在意向治疗分析中，7/241例对照患者（2.9%）存活出院，5/117例有反馈（4.3%）（OR 1.5（95% CI; 0.8，3），P=0.2）。在对所有案件的逻辑回归分析中，目击逮捕（OR 4.2（95% Q 1.6，11），P=0.004）和平均压迫深度（每毫米增加）（OR 1.05（95%CI; 1.01，1.09），P=0.02）与住院率相关。在这项前瞻性非随机研究中，自动反馈改善了院外心脏骤停患者的CPR质量。增加压迫深度与增加短期生存率相关。
Aims: To compare quality of CPR during out-of-hospital cardiac arrest with and without automated feedback.Materials and methods: Consecutive adult, out-of-hospital cardiac arrests of all causes were studied. One hundred and seventy-six episodes (March 2002-October 2003) without feedback were compared to 108 episodes (October 2003-September 2004) where automatic feedback on CPR was given. Automated verbal and visual feedback was based on measured quality with a prototype defibrillator. Quality of CPR was the main outcome measure and survival was reported as specified in the protocol.Results: Average compression depth increased from (mean S.D.) 34 9 to 38 +/- 6mm (mean difference (95% Cl) 4 (2, 6), P < 0.001), and median percentage of compressions with adequate depth (38-51 mm) increased from 24% to 53% (P < 0.001, Mann-Whitney U-test) with feedback. Mean compression rate decreased from 121 +/- 18 to 109 +/- 12 min(-1) (difference -12 (-16, -9), P=0.001). There were no changes in the mean number of ventilations per minute; 11 +/- 5 min(-1) versus 11 +/- 4 min(-1) (difference 0 (-1,1), P=0.8) or the fraction of time without chest compressions; 0.48 +/- 0.18 versus 0.45 +/- 0.17 (difference -0.03 (-0.08, 0.01), P=0.08). With intention to treat analysis 7/241 control patients were discharged alive (2.9%) versus 5/117 with feedback (4.3%) (OR 1.5 (95% Cl; 0.8, 3), P=0.2). In a logistic regression analysis of all cases, witnessed arrest (OR 4.2 (95% Q 1.6, 11), P=0.004) and average compression depth (per mm increase) (OR 1.05 (95% Cl; 1.01, 1.09), P=0.02) were associated with rate of hospital admission.Conclusions: Automatic feedback improved CPR quality in this prospective non-randomised study of out-of-hospitat cardiac arrest. Increased compression depth was associated with increased short-term survival.