Using an audiovisual feedback device improves cardiopulmonary resuscitation performance during day and night - a randomized controlled simulation study

Survival of in-hospital-cardiac-arrests is lower when they occur at night and at weekends than when they occur during the day. Despite numerous studies, there is little evidence regarding the cardiopulmonary resuscitation quality at night and the influence of a feedback device depending on time of day. The present study investigates the differences between chest compressions at night and during the day, with and without the use of a feedback device.

The study was approved by the local Ethics Committee and registered in the German Clinical Trials Register on 22nd of February 2022 (DRKS00027309) prior to inclusion of the first participant. 158 medical professionals were randomized into one of two groups: "no feedback" and "feedback"-group. In both groups, participants carried out three two-minute intervals of cardiopulmonary resuscitation on a manikin at day and at night. Members of the "feedback"-group received guidance by a feedback device. Primary endpoint was the mean compression depth at two time-intervals at the beginning (t₁ = 30-60 s) and the end (t₂ = 480-540 s) of the experience at night. Secondary endpoints included mean compression depth, adequate compression depth (%), compression rate and effective compressions (%).

At night, mean compression depth was significantly higher in the "feedback"-group at t₁ (47.7 ± 7.9 mm, 95% CI [45.6-49.8] vs 42.9 ± 11.0 mm, 95% CI [40.8-45.0]) and t₂ (46.2 ± 7.9 mm, 95% CI [44.0-48.4] vs 39.6 ± 11.6 mm, 95% CI [37.3-41.8]). There was no significant difference in mean compression depth between day and night in the "no feedback"-group (41.4 ± 10.8 mm, 95% CI [39.3-43.5] vs 42.2 ± 10.8 mm, 95% CI [40.1-44.3]) nor in the "feedback-group" (47.4 ± 7.6 mm, 95% CI [45.3-49.4] vs 47.4 ± 7.5 mm; 95% CI [45.4-49.5]).

The use of a real-time audiovisual feedback significantly improved compression depth during the day and night in a manikin-based simulation study with medical professionals.