反馈装置在胸外按压中应用效果的Meta分析

The application of feedback device in cardiopulmonary resuscitation:a meta-analysis

目的 探究使用反馈装置对胸外按压质量的影响。方法 检索Web of science、PubMed、Cochrane library、中国知网、维普和万方数据库,搜索有关使用反馈装置的胸外按压效果的随机对照试验(RCT),检索时限从建库至2022年7月,由2名研究者独立对文献进行筛选、提取研究所需资料并对纳入文献进行质量评价,采用RevMan 5.4.1软件进行Meta分析。结果 共纳入11个RCT,研究对象共880例。Meta分析结果:(1)“成人模拟人”亚组使用反馈装置胸外按压的按压频率低于常规胸外按压[MD=-5.80,95%CI(-11.01,-0.59),P=0.03],而“婴儿模拟人”亚组使用反馈装置胸外按压频率与常规胸外按压差异无统计学意义[MD=9.93,95%CI(-15.27,35.14),P=0.44],该结果显示实施对象不同是研究间存在异质性的原因。(2)使用反馈装置胸外按压深度大于常规胸外按压[MD=3.48,95%CI(1.41,5.55),P=0.001]。亚组分析结果显示,实施者不同是研究间产生异质性的原因。医务人员使用反馈装置辅助胸外按压深度高于常规胸外按压,差异具有统计学意义[MD=4.06,95%CI(0.89,7.23),P=0.01],而非医务人员组间的按压深度差异无统计学意义[MD=3.0,95%CI(-0.32,6.31),P=0.08]。结论 不同人群使用反馈装置辅助胸外按压的效果不同,医务人员能够通过使用反馈装置增加按压深度,同时也需要加强反馈装置在非医务人员胸外按压培训中的应用。由于成人与婴幼儿身体特征存在差异,未来研究中还应大量开展分别以成人和婴幼儿为实施对象的高质量、大样本的RCT,为今后反馈装置在胸外按压中的标准化临床应用提供循证依据。

Objective To evaluate the impact of using feedback device on the quality of cardiopulmonary resuscitation(CPR).Methods The databases of Web of science,PubMed,Cochrane Library,CNKI,VIP and Wanfang were searched for the randomized controlled trial(RCT)on the effect of cardiopulmonary resuscitation using feedback device.The retrieval time was from the establishment of the database to February 2022.Two researchers independently screened the literature after extracting data and evaluating the risk of bias included in the study,Revman 5.4.1 software was used for meta-analysis.Results A total of 11 RCTs were included,including 880 subjects.The results of meta-analysis showed that the compression frequency of feedback CPR in the"adult Simulator"subgroup was lower than that of conventional CPR[MD=-5.80,95%CI(-11.01,-0.59),P=0.03],while there was no significant difference between feedback and conventional in the"infant Simulator"subgroup[MD=9.93,95%CI(-15.27,35.14),P=0.44];Using the feedback device,the CPR pressing depth is greater than the conventional CPR[MD=3.48,95%CI(1.41,5.55),P=0.001].Subgroup analysis showed that different implementers were the source of heterogeneity between studies.When medical staff used the feedback device,the compression depth of CPR was higher than that of conventional CPR,and the difference was statistically significant[MD=4.06,95%CI(0.89,7.23),P=0.01],but there was no significant difference in compression depth between non medical staff groups[MD=3.0,95%CI(-0.32,6.31),P=0.08].Conclusion The effect of using the feedback device is different for different users.The use of the feedback device by medical personnel can increase the depth of compression.It is vital to strengthen the CPR training of non-medical personnel.We should also carry out a large number of high-quality and large sample RCTs for adults and children respectively,so as to provide evidence-based basis for the standardized clinical application of feedback device in cardiopulmonary resuscitation.