Video-Assisted Versus Audio-Assisted Dispatcher Cardiopulmonary Resuscitation for Optimizing Compression Quality in Simulated Scenarios: A Network Meta-Analysis of Randomized Controlled Trials.

IF 2 3区 医学 Q2 EMERGENCY MEDICINE
Xinyu Tan, Xiaokai Wang, Xiangmin Li, Xinbo Yin
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引用次数: 0

Abstract

Objectives: The objective of this study was to evaluate video-assisted dispatcher cardiopulmonary resuscitation (V-DACPR) versus audio-assisted dispatcher CPR impacts on compression quality in simulated out-of-hospital cardiac arrest (OHCA) scenarios.

Methods: Network meta-analysis of randomized controlled trials (RCTs) compared V-DACPR versus audio-assisted dispatcher CPR (A-DACPR) and control. The primary outcome was the compression rate; the secondary outcomes included compression depth, time to first compression, and interruption time. Network meta-analysis of RCTs compared dispatcher-guided CPR with video feedback versus telephone-only instructions in simulated OHCA scenarios using high-fidelity manikins. Three intervention arms were compared: video-assisted CPR, audio-assisted CPR, and unguided CPR (control). Standardized mean differences (SMD) and surface under the cumulative ranking curve (SUCRA) were calculated using Bayesian network meta-analysis methodology.

Results: Fifteen trials (n = 1,556) were analyzed. V-DACPR showed superior compression rates versus A-DACPR (impact size: -21.37, 95% CI: -36.10, -7.41) and control (-43.04, 95% CI: -63.05, -22.52). V-DACPR demonstrated better time to first compression versus control (-42.23, 95% CI: -83.31, -1.42) and favorable trends in compression depth (-5.06, 95% CI: -12.40 to 2.12) and interruption time, though several comparisons between V-DACPR and A-DACPR did not reach statistical significance. Heterogeneity was low to moderate (I2 = 12-63%). Confidence in network meta-analysis (CINeMA) assessment supported moderate to high-quality evidence.

Conclusions: V-DACPR demonstrated significant advantages in compression rate in simulated scenarios, with favorable trends in other quality metrics compared to A-DACPR. These findings support the potential for video assistance technology in dispatcher-guided CPR, particularly for optimizing compression rates. However, these results were observed in simulation studies and require validation in real-world clinical settings to determine their impact on patient outcomes.

视频辅助与音频辅助调度员CPR在模拟场景中优化压缩质量:随机对照试验的网络荟萃分析。
目的:评价视频辅助调度员心肺复苏(CPR)与音频辅助调度员心肺复苏(CPR)对模拟院外心脏骤停(OHCA)情景下按压质量的影响。方法:对随机对照试验(rct)进行网络meta分析,比较视频辅助调度员CPR (V-DACPR)与音频辅助调度员CPR (A-DACPR)和对照组。主要结局是压缩率;次要结局包括压缩深度、首次压缩时间和中断时间。随机对照试验的网络荟萃分析,比较使用高保真假人模拟院外心脏骤停场景中调度员指导的视频反馈CPR与仅电话指令CPR。比较三个干预组:视频辅助CPR、音频辅助CPR和无指导CPR(对照组)。采用贝叶斯网络元分析方法计算标准化平均差异(SMD)和累积排名曲线下曲面(SUCRA)。主要结局是压缩率;次要结局包括压缩深度、首次压缩时间和中断时间。结果:共分析了15项试验(n = 1556)。V-DACPR的压缩率优于A-DACPR(效应值:-21.37,95% CI: -36.10, -7.41)和对照组(-43.04,95% CI: -63.05, -22.52)。V-DACPR首次压缩时间优于对照组(-42.23,95% CI: -83.31, -1.42),压缩深度(-5.06,95% CI: -12.40至2.12)和中断时间有较好的趋势,但V-DACPR和A-DACPR之间的几项比较没有达到统计学意义。异质性为低至中度(I2=12-63%)。CINeMA评价支持中等到高质量的证据。结论:与A-DACPR相比,视频辅助调度员心肺复苏(CPR)在模拟场景中的压缩率方面具有显著优势,在其他质量指标方面也具有有利趋势。这些发现支持视频辅助技术在调度员指导下的心肺复苏中的潜力,特别是在优化压缩率方面。然而,这些结果是在模拟研究中观察到的,需要在现实世界的临床环境中验证,以确定它们对患者预后的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Prehospital Emergency Care
Prehospital Emergency Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.30
自引率
12.50%
发文量
137
审稿时长
1 months
期刊介绍: Prehospital Emergency Care publishes peer-reviewed information relevant to the practice, educational advancement, and investigation of prehospital emergency care, including the following types of articles: Special Contributions - Original Articles - Education and Practice - Preliminary Reports - Case Conferences - Position Papers - Collective Reviews - Editorials - Letters to the Editor - Media Reviews.
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