Abstract 16180: Use of CPR-sensing Defibrillators to Improve Outcomes for In-hospital Cardiac Arrest
Background: Survival among patients who suffer in-hospital cardiac arrest (IHCA) remains suboptimal, with currently reported survival to discharge rates of 9-38%. The use of real-time point-of-care feedback during cardiopulmonary resuscitation (CPR), using CPR-sensing defibrillators, is beneficial in improving CPR quality; however data on their widespread use is limited. Nationally, less than 0.1% of hospitals participating in the Get With The Guidelines-Resuscitation (GWTG-R) program report this data. We investigated the adoption rates of these devices at our hospital and their effect on outcomes.
Methods: In a single-center retrospective cohort study, we reviewed IHCA event and outcome data using an institutional GWTG-R registry from June 2011 to May 2016. Additional clinical data was collected by chart review. Data on CPR-sensing defibrillator (Philips MRx-QCPR) usage was obtained by direct download from defibrillators. Chi square tests were used for analysis.
Results: We captured 256 episodes of IHCA for analysis. Overall, CPR-sensing defibrillators were used in 11.7% of cases, but increased over the course of the study period (trend p=0.002). Return of spontaneous circulation (ROSC) was achieved in 60.7% of cases. Pulseless electrical activity (PEA) and asystole were the most commonly reported initial rhythms (75.4%), followed by VF or pulseless VT (15.2%) and undocumented cases (9.4%). Use of CPR-sensing defibrillators was not associated with any improvement in ROSC (55% vs 62% in those with vs. without CPR-sensing, respectively; p=0.703). Similarly, no differences were found in survival to discharge, neurologically intact discharge (Cerebral Performance Category of 1 or 2) or one year survival.
Conclusions: Although rates of adoption of CPR quality assessment tools are rising in our hospital, these devices are used only in a small minority of our cardiac arrest cases. Usage in our small subset was not associated with any improvement in clinical outcomes. Although surprising, these results may contrast with the positive results in the community because of greater resources and ACLS-trained providers in the hospital setting. Sustained efforts are needed to increase usage of these quality monitors and evaluate their efficacy.
Author Disclosures: A. Harzand: None. A.J. Shah: None. A. Zafari: None.
- © 2016 by American Heart Association, Inc.