Real-time compression feedback for patients with in-hospital cardiac arrest: a multi-center randomized controlled clinical trial

Reza Goharani,
Amir Vahedian-Azimi,
Behrooz Farzanegan,
Farshid R. Bashar,
Mohammadreza Hajiesmaeili,
Seyedpouzhia Shojaei,
Seyed J. Madani,
Keivan Gohari-Moghaddam,
Sevak Hatamian,
Seyed M. M. Mosavinasab,
Masoum Khoshfetrat,
Mohammad A. Khabiri Khatir,
Andrew C. MillerEmail author View ORCID ID profile and
for the MORZAK Collaborative

Journal of Intensive Care20197:5

https://doi.org/10.1186/s40560-019-0357-5

Received: 8 November 2018
Accepted: 3 January 2019
Published: 22 January 2019

Abstract

Objective

To determine if real-time compression feedback using a non-automated hand-held device improves patient outcomes from in-hospital cardiac arrest (IHCA).

Methods

We conducted a prospective, randomized, controlled, parallel study (no crossover) of patients with IHCA in the mixed medical–surgical intensive care units (ICUs) of eight academic hospitals. Patients received either standard manual chest compressions or compressions performed with real-time feedback using the Cardio First Angel™ (CFA) device. The primary outcome was sustained return of spontaneous circulation (ROSC), and secondary outcomes were survival to ICU and hospital discharge.

Results

One thousand four hundred fifty-four subjects were randomized; 900 were included. Sustained ROSC was significantly improved in the CFA group (66.7% vs. 42.4%, P < 0.001), as was survival to ICU discharge (59.8% vs. 33.6%) and survival to hospital discharge (54% vs. 28.4%, P < 0.001). Outcomes were not affected by intra-group comparisons based on intubation status. ROSC, survival to ICU, and hospital discharge were noted to be improved in inter-group comparisons of non-intubated patients, but not intubated ones.