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Meta-Analysis
. 2022 Oct;17(7):2143-2158.
doi: 10.1007/s11739-022-03041-6. Epub 2022 Aug 29.

The impact of cognitive aids on resuscitation performance in in-hospital cardiac arrest scenarios: a systematic review and meta-analysis

Francesco Corazza  1 , Elena Fiorese  2 , Marta Arpone  2 , Giacomo Tardini  2 , Anna Chiara Frigo  3 , Adam Cheng  4 , Liviana Da Dalt  1   2 , Silvia Bressan  5   6
Affiliations
Meta-Analysis

The impact of cognitive aids on resuscitation performance in in-hospital cardiac arrest scenarios: a systematic review and meta-analysis

Francesco Corazza et al. Intern Emerg Med. 2022 Oct.

Abstract

Different cognitive aids have been recently developed to support the management of cardiac arrest, however, their effectiveness remains barely investigated. We aimed to assess whether clinicians using any cognitive aids compared to no or alternative cognitive aids for in-hospital cardiac arrest (IHCA) scenarios achieve improved resuscitation performance. PubMed, EMBASE, the Cochrane Library, CINAHL and ClinicalTrials.gov were systematically searched to identify studies comparing the management of adult/paediatric IHCA simulated scenarios by health professionals using different or no cognitive aids. Our primary outcomes were adherence to guideline recommendations (overall team performance) and time to critical resuscitation actions. Random-effects model meta-analyses were performed. Of the 4.830 screened studies, 16 (14 adult, 2 paediatric) met inclusion criteria. Meta-analyses of eight eligible adult studies indicated that the use of electronic/paper-based cognitive aids, in comparison with no aid, was significantly associated with better overall resuscitation performance [standard mean difference (SMD) 1.16; 95% confidence interval (CI) 0.64; 1.69; I2 = 79%]. Meta-analyses of the two paediatric studies, showed non-significant improvement of critical actions for resuscitation (adherence to guideline recommended sequence of actions, time to defibrillation, rate of errors in defibrillation, time to start chest compressions), except for significant shorter time to amiodarone administration (SMD - 0.78; 95% CI - 1.39; - 0.18; I2 = 0). To conclude, the use of cognitive aids appears to have benefits in improving the management of simulated adult IHCA scenarios, with potential positive impact on clinical practice. Further paediatric studies are necessary to better assess the impact of cognitive aids on the management of IHCA scenarios.

Keywords: Cognitive aid; Heart arrest; Resuscitation; Simulation training; Support tool.

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Conflict of interest statement

None of the authors have any financial or nonfinancial competing interests to declare.

Figures

Fig. 1
Fig. 1
PRISMA Flow Diagram of study selection
Fig. 2
Fig. 2
Meta-analyses of adult studies for the outcome of teams’ overall performance
Fig. 3
Fig. 3
Meta-analyses of outcomes for paediatric studies
See this image and copyright information in PMC

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