Video-assisted bystander cardiopulmonary resuscitation improves the quality of chest compressions during simulated cardiac arrests: A systemic review and meta-analysis

BACKGROUND It remains unclear whether video aids can improve the quality of bystander cardiopulmonary resuscitation(CPR).AIM To summarize simulation-based studies aiming at improving bystander CPR associated with the quality of chest compression and time-related quality parameters.METHODS The systematic review was conducted according to the PRISMA guidelines.All relevant studies were searched through PubMed,EMBASE,Medline and Cochrane Library databases.The risk of bias was evaluated using the Cochrane collaboration tool.RESULTS A total of 259 studies were eligible for inclusion,and 6 randomised controlled trial studies were ultimately included.The results of meta-analysis indicated that video-assisted CPR(V-CPR)was significantly associated with the improved mean chest compression rate[OR=0.66(0.49-0.82),P<0.001],and the proportion of chest compression with correct hand positioning[OR=1.63(0.71-2.55),P<0.001].However,the difference in mean chest compression depth was not statistically significant[OR=0.18(-0.07-0.42),P=0.15],and V-CPR was not associated with the time to first chest compression compared to telecommunicator CPR[OR=-0.12(-0.88-0.63),P=0.75].CONCLUSION Video real-time guidance by the dispatcher can improve the quality of bystander CPR to a certain extent.However,the quality is still not ideal,and there is a lack of guidance caused by poor video signal or inadequate interaction.

Biological pacemaker:from biological experiments to computational simulation

Pacemaking dysfunction has become a significant disease that may contribute to heart rhythm disorders,syncope,and even death.Up to now,the best way to treat it is to implant electronic pacemakers.However,these have many disadvantages such as limited battery life,infection,and fixed pacing rate.There is an urgent need for a biological pacemaker(bio-pacemaker).This is expected to replace electronic devices because of its low risk of complications and the ability to respond to emotion.Here we survey the contemporary development of the bio-pacemaker by both experimental and computational approaches.The former mainly includes gene therapy and cell therapy,whilst the latter involves the use of multi-scale computer models of the heart,ranging from the single cell to the tissue slice.Up to now,a bio-pacemaker has been successfully applied in big mammals,but it still has a long way from clinical uses for the treatment of human heart diseases.It is hoped that the use of the computational model of a bio-pacemaker may accelerate this process.Finally,we propose potential research directions for generating a bio-pacemaker based on cardiac computational modeling.