• Amir Vahedian-Azimi, Mohammadreza Hajiesmaeili, Ali Amirsavadkouhi, Hamidreza Jamaati, Morteza Izadi, Seyed J Madani, Seyed M R Hashemian, and Andrew C Miller.
• Trauma Research Center and Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
• Crit Care. 2016 May 17; 20 (1): 147.

BackgroundA number of cardiopulmonary resuscitation (CPR) adjunct devices have been developed to improve the consistency and quality of manual chest compressions. We investigated whether a CPR feedback device would improve CPR quality and consistency, as well as patient survival.MethodsWe conducted a randomized controlled study of patients undergoing CPR for cardiac arrest in the mixed medical-surgical intensive care units of four academic teaching hospitals. Patients were randomized to receive either standard manual CPR or CPR using the Cardio First Angel™ CPR feedback device. Recorded variables included guideline adherence, CPR quality, return of spontaneous circulation (ROSC) rates, and CPR-associated morbidity.ResultsA total of 229 subjects were randomized; 149 were excluded; and 80 were included. Patient demographics were similar. Adherence to published CPR guidelines and CPR quality was significantly improved in the intervention group (p < 0.0001), as were ROSC rates (72 % vs. 35 %; p = 0.001). A significant decrease was observed in rib fractures (57 % vs. 85 %; p = 0.02), but not sternum fractures (5 % vs. 17 %; p = 0.15).ConclusionsUse of the Cardio First Angel™ CPR feedback device improved adherence to published CPR guidelines and CPR quality, and it was associated with increased rates of ROSC. A decrease in rib but not sternum fractures was observed with device use. Further independent prospective validation is warranted to determine if these results are reproducible in other acute care settings.Trial RegistrationClinicalTrials.gov identifier: NCT02394977 . Registered on 5 Mar 2015.

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