Lyngby, Rasmus Meyer, Händel, Mina Nicole, Chistensen, Anne Mielke, Nikoletou, Dimitra, Folke, Fredrik, Christensen, Helle Collatz, Barfod, Charlotte and Quinn, Tom (2021) Effect of real-time and post-event feedback in out-of-hospital cardiac arrest attended by EMS : a systematic review and meta-analysis. Resuscitation Plus, 6, p. 100101. ISSN (online) 2666-5204

Abstract

A systematic review to determine if cardiopulmonary resuscitation (CPR) guided by either real-time or post-event feedback could improve CPR quality or patient outcome compared to unguided CPR in out-of-hospital cardiac arrest (OHCA). Four databases were searched; PubMed, Embase, CINAHL, and Cochrane Library in August 2020 for post 2010 literature on OHCA in adults. Critical outcomes were chest compression depth, rate and fraction. Important outcomes were any return of spontaneous circulation, survival to hospital and survival to discharge. A total of 9464 studies were identified with 61 eligibility for full text screening. A total of eight studies was included in the meta-analysis. Five studies investigated real-time feedback and three investigated post-event feedback. Meta-analysis revealed that real-time feedback statistically improves compression depth and rate while post-event feedback improved depth and fraction. Feedback did not statistically improve patient outcome but an improvement in absolute numbers revealed a clinical effect of feedback. Heterogenity varied from "might not be important" to "considerable". To significantly improve CPR quality real-time and post-event feedback should be combined. Neither real-time nor post event feedback could statistically be associated with patient outcome however, a clinical effect was detected. The conclusions reached were based on few studies of low to very low quality. CRD42019133881. [Abstract copyright: © 2021 The Authors.]

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Official URL:	https://doi.org/10.1016/j.resplu.2021.100101
Item Type:	Article
Additional Information:	This work is supported by the TrygFoundation, Laerdal Foundation and Oak Foundation.
Uncontrolled Keywords:	CCD; chest compression depth; CCF; chest compression fraction; CCR; chest compression rate; CI; confidence interval; CINAHL; cumulative index to nursing and allied health literature; CPR quality; CPR; cardiopulmonary resuscitation; EMS; emergency medical service; ERC; European Resuscitation Council; GRADE; grades of recommendation; assessment; development; evaluation; IHCA; in-hospital cardiac arrest; MD; mean difference; MESH; medical subject headings; OHCA; out-of-hospital cardiac arrest; PICO; population; intervention; comparison and outcome; PRISMA; preferred reporting items for systematic reviews and meta-analyses; PROSPERO; international prospective register of systematic reviews; post-event feedback; RCT; randomised controlled trial; ROBINS-I; Cochrane’s risk of bias in non-randomized studies – of interventions; ROSC; return of spontaneous circulation; RR; risk ratio; real-time feedback
Research Area:	Research Areas > Allied health professions and studies Research Areas > Primary care and other community based clinical subjects
Faculty, School or Research Centre:	Faculty of Health, Social Care and Education Faculty of Health, Social Care and Education > Centre for Health and Social Care Research Faculty of Health, Social Care and Education > School of Allied Health, Midwifery and Social Care
Date Deposited:	12 Mar 2021 09:21
Last Modified:	01 Aug 2022 10:48
DOI:	https://doi.org/10.1016/j.resplu.2021.100101
URI:	https://eprints.kingston.ac.uk/id/eprint/48579

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