Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2023; 15(10): 531-541
Published online Oct 26, 2023. doi: 10.4330/wjc.v15.i10.531
Do cardiopulmonary resuscitation real-time audiovisual feedback devices improve patient outcomes? A systematic review and meta-analysis
Nitish Sood, Anish Sangari, Arnav Goyal, Christina Sun, Madison Horinek, Joseph Andy Hauger, Lane Perry
Nitish Sood, Anish Sangari, Arnav Goyal, Madison Horinek, Lane Perry, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States
Christina Sun, Dental College of Georgia, Augusta University, Augusta, GA 30912, United States
Joseph Andy Hauger, Department of Chemistry and Physics, Augusta University, Augusta, GA 30912, United States
Author contributions: Sood N, Sangari A, and Goyal A contributed equally to this work; Sood N and Sangari A designed the research study; Sood N, Sangari A, and Goyal A performed the research; Sood N performed the statistical analysis; Sood N, Sangari A, Goyal A, Sun C, Horinek M, Hauger JA, and Perry L analyzed the data and wrote the manuscript; Sood N, Sangari A, Goyal A, Sun C, Horinek M, Hauger JA, and Perry L reviewed the manuscript before submission; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nitish Sood, BSc, Medical College of Georgia, Augusta University, No. 1120 15th Street, Augusta, GA 30912, United States. nsood@augusta.edu
Received: June 7, 2023
Peer-review started: June 7, 2023
First decision: July 4, 2023
Revised: July 23, 2023
Accepted: August 3, 2023
Article in press: August 3, 2023
Published online: October 26, 2023
Processing time: 139 Days and 4.3 Hours
ARTICLE HIGHLIGHTS
Research background

Cardiac arrest is a leading cause of mortality in America and continues to grow in prevalence. Cardiopulmonary resuscitation (CPR) increases survival outcomes in cases of cardiac arrest; however, healthcare workers often do not perform CPR within recommended guidelines. Real-time audiovisual feedback (RTAVF) devices provide live feedback on CPR performance and subsequently improves the quality of CPR performed.

Research motivation

Effective CPR in cardiac arrest is critical to emergent management and stabilization. RTAVF-assisted CPR devices may improve performance, compliance with recommended guidelines, and survival, therefore, this systematic review and meta-analysis seeks to compare the effect of RTAVF-assisted CPR devices with conventional CPR on patient outcomes in the setting of in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA).

Research objectives

To investigate the impact of RTAVF-assisted CPR on patient outcomes and CPR quality with respect to in- and OHCA.

Research methods

The literature search was conducted on PubMed, SCOPUS, the Cochrane Library, and EMBASE from inception to July 27, 2020, for studies reporting patient outcomes and/or CPR quality metrics between an RTAVF-assisted CPR and conventional CPR in the setting of IHCA or OHCA. The primary outcomes of interest extracted and analyzed were return of spontaneous circulation (ROSC) and survival to hospital discharge (SHD). Data was analyzed using R statistical software 4.2.0. Results were statistically significant if P < 0.05.

Research results

Thirteen studies (n = 17600) were included after deduplication, screening, and full-text analysis. Patients were on average 69 ± 17.5 years old, with 7022 (39.8%) female patients. Overall pooled ROSC was 37% among all studies. RTAVF-assisted CPR significantly improved ROSC in the case of IHCAs and improved chest compression depth. No significant improvements were seen in ROSC in cases of OHCA, SHD, or compression rate.

Research conclusions

This meta-analysis found that RTAVF-assisted CPR increases ROSC in the setting of IHCA but has no significant effect on ROSC in the setting of OHCA or SHD. Consistent with previous manikin simulation studies, the meta-analysis found that RTAVF-assisted CPR results in improvements in both chest compression rate and depth.

Research perspectives

Cardiac arrest remains a leading cause of mortality with increasing prevalence. The findings of this study suggest that RTAVF-assisted CPR may improve ROSC in the setting of IHCAs but not in the setting of OHCA. Hospitals should prioritize implementing RTAVF devices in areas with the highest rates of IHCA rather than to paramedics or ambulances.