Effect of the Cardio First Angel™ device on CPR indices: a randomized controlled clinical trial

Amir Vahedian-Azimi, Mohammadreza Hajiesmaeili, Ali Amirsavadkouhi, Hamidreza Jamaati, Morteza Izadi, Seyed J Madani, Seyed M R Hashemian, Andrew C Miller, Amir Vahedian-Azimi, Mohammadreza Hajiesmaeili, Ali Amirsavadkouhi, Hamidreza Jamaati, Morteza Izadi, Seyed J Madani, Seyed M R Hashemian, Andrew C Miller

Abstract

Background: A number of cardiopulmonary resuscitation (CPR) adjunct devices have been developed to improve the consistency and quality of manual chest compressions. We investigated whether a CPR feedback device would improve CPR quality and consistency, as well as patient survival.

Methods: We conducted a randomized controlled study of patients undergoing CPR for cardiac arrest in the mixed medical-surgical intensive care units of four academic teaching hospitals. Patients were randomized to receive either standard manual CPR or CPR using the Cardio First Angel™ CPR feedback device. Recorded variables included guideline adherence, CPR quality, return of spontaneous circulation (ROSC) rates, and CPR-associated morbidity.

Results: A total of 229 subjects were randomized; 149 were excluded; and 80 were included. Patient demographics were similar. Adherence to published CPR guidelines and CPR quality was significantly improved in the intervention group (p < 0.0001), as were ROSC rates (72 % vs. 35 %; p = 0.001). A significant decrease was observed in rib fractures (57 % vs. 85 %; p = 0.02), but not sternum fractures (5 % vs. 17 %; p = 0.15).

Conclusions: Use of the Cardio First Angel™ CPR feedback device improved adherence to published CPR guidelines and CPR quality, and it was associated with increased rates of ROSC. A decrease in rib but not sternum fractures was observed with device use. Further independent prospective validation is warranted to determine if these results are reproducible in other acute care settings.

Trial registration: ClinicalTrials.gov identifier: NCT02394977 . Registered on 5 Mar 2015.

Keywords: CPR outcomes; Cardiac arrest; Cardio First Angel; Cardiopulmonary resuscitation.

Figures

Fig. 1
Fig. 1
Flowchart of patient enrollment. CFA Cardio First Angel™, CPR cardiopulmonary resuscitation, ICU intensive care unit
Fig. 2
Fig. 2
Illustration of proper positioning of the Cardio First Angel™ device. a The device is positioned over the lower one-third of the sternum. The rescuer-side portion consists of a red, round push-button that displays a pictogram illustrating proper device use. b The push-button fits in the palm of the rescuer’s hand as it would lie on the sternum during manual cardiopulmonary resuscitation (CPR). c The rescuer should maintain straight arms and back and flex at the waist as in standard manual CPR

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