Abstract 18583: Use of a Metronome to Improve Quality of In-Hospital Cardiopulmonary Resuscitation
Introduction: Survival is known to be poor for both out-of-hospital and in-hospital cardiac arrest (IHCA). High-quality cardiopulmonary resuscitation (CPR) is the primary component in influencing return of spontaneous circulation (ROSC) and intact survival from cardiac arrest. Studies have shown that achieving a chest compression rate between 100 and 120 min-1 is associated with improved survival. Metronome-guided compressions have shown improvement in chest compression metrics during out-of-hospital CPR.
Objectives: The objective of this study was to observe CPR quality metrics, such as chest compression rate, following implementation of metronome-guided chest compressions during CPR for IHCA.
Methods: Zoll® R series defibrillators were deployed at our institution in February 2015 with the ability to collect CPR quality data, including compression rate (target: 100-120 min-1) and depth (target: >2 inches). Starting in October 2015, an audible metronome was utilized during CPR, with a programmed rate of 100-110 min-1, depending on the device utilized. CPR quality data was analyzed using CodeNet® (Zoll®). A retrospective cohort analysis was conducted. Categorical and distributive data were analyzed using Fisher’s exact and two-tailed Student’s t-test, respectively.
Results: Between February 2015 and February 2016, 138 pulseless cardiac arrest events occurred in our facility - 63 of which had CPR quality data recorded. Forty-five events (34 patients) were pre-initiation of metronome-guided compressions and 18 events (16 patients) were post-initiation. Use of metronome improved compressions performed within the target rate from 31.3 to 56.4% (p=0.0015) as well as the percentage within target rate and depth from 27.2 to 48.2% (p=0.0078). There was no deleterious effect on chest compression depth. There were statistically insignificant trends in improved ROSC from 53.3 to 77.8% (p=0.073), and survival to hospital discharge from 17.6 to 37.5% (p=0.13).
Conclusions: Use of metronome-guided chest compressions during IHCA was associated with improved target compression rate and an improvement in overall CPR quality, which may translate to improved clinical outcomes.
Author Disclosures: J. Bolstridge: None. H.M. Delaney: None. R.I. Matos: None.
- © 2016 by American Heart Association, Inc.