Effect of real-time and post-event feedback in out-of-hospital cardiac arrest attended by EMS: a systematic review and meta-analysis

Rasmus Meyer Lyngby; Mina Nicole H├ñndel; Anne Mielke Chistensen; Dimitra Nikoletou; Fredrik Folke; Helle Collatz Christensen; Charlotte Barfod; Tom Quinn

doi:10.1016/j.resplu.2021.100101

Effect of real-time and post-event feedback in out-of-hospital cardiac arrest attended by EMS: a systematic review and meta-analysis

Rasmus Meyer Lyngby
, Mina Nicole H├ñndel
, Anne Mielke Chistensen
, Dimitra Nikoletou
, Fredrik Folke
, Helle Collatz Christensen
, Charlotte Barfod
, Tom Quinn

Research output: Contribution to journal › Article › peer-review

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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.]

Original language	English
Article number	100101
Journal	Resuscitation Plus
Volume	6
Early online date	12 Mar 2021
DOIs	https://doi.org/10.1016/j.resplu.2021.100101
Publication status	Published - 30 Jun 2021

Bibliographical note

Note: This work is supported by the TrygFoundation, Laerdal Foundation and Oak Foundation.

Keywords

Allied health professions and studies
CCD
CCF
CCR
CI
CINAHL
CPR
CPR quality
Cochrane's risk of bias in non-randomized studies - of interventions
EMS
ERC
European Resuscitation Council
GRADE
IHCA
MD
MESH
OHCA
PICO
PRISMA
PROSPERO
RCT
ROBINS-I
ROSC
RR
assessment
cardiopulmonary resuscitation
chest compression depth
chest compression fraction
chest compression rate
comparison and outcome
confidence interval
cumulative index to nursing and allied health literature
development
emergency medical service
evaluation
grades of recommendation
in-hospital cardiac arrest
international prospective register of systematic reviews
intervention
mean difference
medical subject headings
out-of-hospital cardiac arrest
population
post-event feedback
preferred reporting items for systematic reviews and meta-analyses
randomised controlled trial
real-time feedback
return of spontaneous circulation
risk ratio

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10.1016/j.resplu.2021.100101

Lyngby-R-48579-VoRFinal published version, 2.38 MBLicence: CC BY-NC-ND

https://doi.org/10.1016/j.resplu.2021.100101

Cite this

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title = "Effect of real-time and post-event feedback in out-of-hospital cardiac arrest attended by EMS: a systematic review and meta-analysis",

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author = "Lyngby, \{Rasmus Meyer\} and H├{\~n}ndel, \{Mina Nicole\} and Chistensen, \{Anne Mielke\} and Dimitra Nikoletou and Fredrik Folke and Christensen, \{Helle Collatz\} and Charlotte Barfod and Tom Quinn",

note = "Note: This work is supported by the TrygFoundation, Laerdal Foundation and Oak Foundation.",

year = "2021",

month = jun,

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doi = "10.1016/j.resplu.2021.100101",

language = "English",

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T1 - Effect of real-time and post-event feedback in out-of-hospital cardiac arrest attended by EMS

T2 - a systematic review and meta-analysis

AU - Lyngby, Rasmus Meyer

AU - H├ñndel, Mina Nicole

AU - Chistensen, Anne Mielke

AU - Nikoletou, Dimitra

AU - Folke, Fredrik

AU - Christensen, Helle Collatz

AU - Barfod, Charlotte

AU - Quinn, Tom

N1 - Note: This work is supported by the TrygFoundation, Laerdal Foundation and Oak Foundation.

PY - 2021/6/30

Y1 - 2021/6/30

N2 - 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.]

AB - 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.]

KW - Allied health professions and studies

KW - CCD

KW - CCF

KW - CCR

KW - CI

KW - CINAHL

KW - CPR

KW - CPR quality

KW - Cochrane's risk of bias in non-randomized studies - of interventions

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KW - ERC

KW - European Resuscitation Council

KW - GRADE

KW - IHCA

KW - MD

KW - MESH

KW - OHCA

KW - PICO

KW - PRISMA

KW - PROSPERO

KW - RCT

KW - ROBINS-I

KW - ROSC

KW - RR

KW - assessment

KW - cardiopulmonary resuscitation

KW - chest compression depth

KW - chest compression fraction

KW - chest compression rate

KW - comparison and outcome

KW - confidence interval

KW - cumulative index to nursing and allied health literature

KW - development

KW - emergency medical service

KW - evaluation

KW - grades of recommendation

KW - in-hospital cardiac arrest

KW - international prospective register of systematic reviews

KW - intervention

KW - mean difference

KW - medical subject headings

KW - out-of-hospital cardiac arrest

KW - population

KW - post-event feedback

KW - preferred reporting items for systematic reviews and meta-analyses

KW - randomised controlled trial

KW - real-time feedback

KW - return of spontaneous circulation

KW - risk ratio

U2 - 10.1016/j.resplu.2021.100101

DO - 10.1016/j.resplu.2021.100101

M3 - Article

SN - 2666-5204

VL - 6

JO - Resuscitation Plus

JF - Resuscitation Plus

M1 - 100101

ER -

Effect of real-time and post-event feedback in out-of-hospital cardiac arrest attended by EMS: a systematic review and meta-analysis

Abstract

Bibliographical note

Keywords

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