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Review
. 2024 Oct 8;13(19):5989.
doi: 10.3390/jcm13195989.

The Role of Different Feedback Devices in the Survival of Patients in Cardiac Arrest: Systematic Review with Meta-Analysis

Luca Gambolò  1   2 , Pasquale Di Fronzo  3 , Giuseppe Ristagno  4   5 , Sofia Biserni  3 , Martina Milazzo  3 , Delia Marta Socaci  3 , Leopoldo Sarli  3 , Giovanna Artioli  3 , Antonio Bonacaro  3 , Giuseppe Stirparo  1
Affiliations
Review

The Role of Different Feedback Devices in the Survival of Patients in Cardiac Arrest: Systematic Review with Meta-Analysis

Luca Gambolò et al. J Clin Med. .

Abstract

Background: Cardiac arrest is a critical condition affecting approximately 1 in every 1000 people in Europe. Feedback devices have been developed to enhance the quality of chest compressions during CPR, but their clinical impact remains uncertain. This study aims to evaluate the effect of feedback devices on key clinical outcomes in adult patients experiencing both out-of-hospital (OHCA) and in-hospital cardiac arrest (IHCA). The primary objective is to assess their impact on the return of spontaneous circulation (ROSC); secondary objectives include the evaluation of neurological status and survival to discharge. Methods: A systematic review was conducted following PRISMA guidelines, utilizing databases including PubMed, Scopus, Web of Science, and Embase. Studies published between 2000 and 2023 comparing CPR with and without the use of feedback devices were included. A fixed-effects network meta-analysis was performed for ROSC and survival, while a frequentist meta-analysis was conducted for neurological outcomes. Results: Twelve relevant studies met the inclusion criteria. The meta-analysis results showed that the use of audiovisual feedback devices significantly increases the likelihood of ROSC (OR 1.26, 95% CI 1.13-1.41, p < 0.0001) and survival (OR 1.52, 95% CI 1.27-1.81, p < 0.0001) compared to CPR without feedback. However, the effect of metronomes did not reach statistical significance. Conclusions: Feedback devices, particularly audiovisual ones, are associated with improved clinical outcomes in cardiac arrest patients. Their use should be encouraged in both training settings and real-life emergency scenarios to enhance survival rates and ROSC. However, further studies are needed to confirm long-term impacts and to explore the potential benefits of metronomes.

Keywords: IHCA; OHCA; cardiopulmonary resuscitation; feedback devices; return of spontaneous circulation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Selection process flow diagram.
Figure 2
Figure 2
Netgraph For ROSC.
Figure 3
Figure 3
Forest plot for ROSC; Tau = 0.42, Tau2 = 0.17, I2 = 80.3% (66.4–88.4%).
Figure 4
Figure 4
Netgraph for survival.
Figure 5
Figure 5
Forest plot for survival: Tau = 0.63, Tau2 = 0.40, I2 = 87.1% (74.3–93.5%).
Figure 6
Figure 6
Forest plot for neurological status [15,26].
See this image and copyright information in PMC

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