The incidence of sudden cardiac arrest in North America and Europe has been estimated to be between 50 to 100 per 100,000 in general population. Immediate initiation of cardiopulmonary resuscitation (CPR) and early defibrillation are keys to survival from sudden cardiac arrest. CPR is comprised of external chest compressions and mouth-to-mouth ventilation. Despite the development of CPR and other advanced resuscitation techniques, the survival rates from sudden cardiac arrest remain low; 1 to 6 percent in the out-of-hospital setting. The rates of survival-to-hospital discharge from out-of-hospital cardiac arrest range from 5 to 10 percent. Low-quality CPR performance is one of the factors contributing to poor survival outcomes. Five key components of high quality CPR include minimizing interruptions in chest compressions, providing adequate rate and depth of compression, avoiding leaning on chest between compressions, and avoiding excessive ventilation. Current technology incorporated into a CPR device such as a defibrillator can provide real-time audiovisual feedback, thus enhancing CPR performance to more closely with guidelines. Studies have shown that real-time feedback devices used in both training and medical settings could improve CPR quality by providing information about the quality of CPR components such as chest compression rate and depth, chest compression fraction, and ventilation rate. However, it was unclear if CPR quality improved by such devices could translate into improving survival in humans.

The aim of this report is to review the clinical effectiveness and guidelines regarding the use of CPR feedback devices for adult patients in cardiac arrest.

Contents

• CONTEXT AND POLICY ISSUES
• RESEARCH QUESTIONS
• KEY FINDINGS
• METHODS
  • Literature Search Strategy
  • Selection Criteria and Methods
  • Exclusion Criteria
  • Critical Appraisal of Individual Studies
• SUMMARY OF EVIDENCE
  • Quantity of Research Available
  • Summary of Study Characteristics
  • Summary of Critical Appraisal
  • Summary of Findings
  • Limitations
• CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING
• REFERENCES
• APPENDIX 1 Selection of Included Studies
• APPENDIX 2 Characteristics of Included Clinical Studies
• APPENDIX 3 Grading of Recommendations and Levels of Evidence
• APPENDIX 4 Summary of Study Strengths and Limitations
• APPENDIX 5 Summary of Study Strengths and Limitations – Guidelines
• APPENDIX 6 Main Study Findings and Authors’ Conclusions – Clinical
• APPENDIX 7 Summary of Guideline Recommendations

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources and a summary of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.