Abstract
Purposes
Chest compressions require physical effort leading to increased fatigue and rapid
degradation in the quality of cardiopulmonary resuscitation overtime. Despite harmful
effect of interrupting chest compressions, current guidelines recommend that rescuers
switch every 2 minutes. The impact on the quality of chest compressions during extended
cardiopulmonary resuscitation has yet to be assessed.
Basic procedures
We conducted randomized crossover study on manikin (ResusciAnne; Laerdal). After randomization,
60 professional emergency rescuers performed 2 × 10 minutes of continuous chest compressions
with and without a feedback device (CPRmeter). Efficient compression rate (primary
outcome) was defined as the frequency target reached along with depth and leaning
at the same time (recorded continuously).
Main findings
The 10-minute mean efficient compression rate was significantly better in the feedback
group: 42% vs 21% (P< .001). There was no significant difference between the first (43%) and the tenth
minute (36%; P= .068) with feedback. Conversely, a significant difference was evident from the second
minute without feedback (35% initially vs 27%; P< .001). The efficient compression rate difference with and without feedback was significant
every minute, from the second minute onwards. CPRmeter feedback significantly improved
chest compression depth from the first minute, leaning from the second minute and
rate from the third minute.
Principal conclusions
A real-time feedback device delivers longer effective, steadier chest compressions
over time. An extrapolation of these results from simulation may allow rescuer switches
to be carried out beyond the currently recommended 2 minutes when a feedback device
is used.
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Article Info
Publication History
Published online: May 28, 2016
Accepted:
May 25,
2016
Received:
May 9,
2016
Footnotes
☆Funding: Internally funded by CHU de Caen, Pôle Réanimations Anesthésie SAMU, Caen, F-14000, France. This work was supported by institutional (University Hospital of Caen, Caen, France) and departmental resources (Department of Anaesthesiology, CHRU de Caen, Caen, France). The manufacturer (Laerdal Medical) provided 2 Q-CPR feedback devices for the study period.
☆☆Conflict of interest: Laerdal Medical France lent 2 CPRmeter for the study. Clément Buléon's fees to SESAM 2011 in Grenada and to SESAM 2013 in Paris were offered by Laerdal Medical France.
★ClinalTrials ID: NCT02322359.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
