Release velocity ImprovemenT with a new Metronome guIding chest COmpressions: The RITMICO simulation study
Background and trial design: Outcomes of out-of-hospital cardiac arrest vary significantly, often due to the quality of cardiopulmonary resuscitation (CPR) provided. Automated real-time feedback devices have been explored to enhance CPR skills, but few devices currently ensure proper chest recoil. T...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520425000049 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832595708142682112 |
|---|---|
| author | Maria Luce Caputo Giuliana Monachino Ruggero Cresta Alessia Currao Enrico Baldi Simone Savastano Andrea Cortegiani Mariachiara Ippolito Sara Accetta Alessandra Gargano Camilla Metelmann Bibiana Metelmann Carlos Ramon Hölzing Julian Ganter Michael Patrick Müller Claudio Benvenuti Stefania Tomola Pierangelo Pinetti Pier Luigi Ingrassia Francesca Dalia Faraci Angelo Auricchio |
| author_facet | Maria Luce Caputo Giuliana Monachino Ruggero Cresta Alessia Currao Enrico Baldi Simone Savastano Andrea Cortegiani Mariachiara Ippolito Sara Accetta Alessandra Gargano Camilla Metelmann Bibiana Metelmann Carlos Ramon Hölzing Julian Ganter Michael Patrick Müller Claudio Benvenuti Stefania Tomola Pierangelo Pinetti Pier Luigi Ingrassia Francesca Dalia Faraci Angelo Auricchio |
| author_sort | Maria Luce Caputo |
| collection | DOAJ |
| description | Background and trial design: Outcomes of out-of-hospital cardiac arrest vary significantly, often due to the quality of cardiopulmonary resuscitation (CPR) provided. Automated real-time feedback devices have been explored to enhance CPR skills, but few devices currently ensure proper chest recoil. This study aimed to assess whether a double-click metronome could improve chest compressions (CC) metrics and particularly CC release velocity (CCRV) during CPR manikin simulation. Methods: We developed and tested a double-click metronome for CPR, where the first click signals the compression and the second click marks the end of chest release. We performed a multicenter non-blinded, randomized, controlled trial including volunteers with different levels of CPR expertise. Three CC metrics—depth, rate, and CCRV—were measured using an automated external defibrillator equipped with pads for CPR quality analysis. Results: 503 volunteers participated in the study, with 54% being male and a mean age of 34 ± 12 years. The median CCRV and CC depth achieved with the double-click metronome were significantly higher compared to the standard metronome (median difference 6 mm/s, IQR-15.2, 28.5, +1.5%, p < 0.001; median difference 0.1 cm, +2.5%, IQR −0.1, 0.4, p < 0.001). The double-click metronome led to significant improvements in CC depth and CCRV across all volunteer categories, with the greater effect observed in first responders and in non-specialized healthcare personnel. Conclusions: Compared to a standard metronome, the double-click metronome significantly enhances CPR quality. If further validated in real resuscitations, this new audio prompt could be a valuable tool for integration into devices designed for out-of-hospital cardiac arrest resuscitation, as well as a training tool to improve CPR quality. |
| format | Article |
| id | doaj-art-b706af5ef6604b7d983d343f98ca6b62 |
| institution | Kabale University |
| issn | 2666-5204 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj-art-b706af5ef6604b7d983d343f98ca6b622025-01-18T05:05:17ZengElsevierResuscitation Plus2666-52042025-01-0121100867Release velocity ImprovemenT with a new Metronome guIding chest COmpressions: The RITMICO simulation studyMaria Luce Caputo0Giuliana Monachino1Ruggero Cresta2Alessia Currao3Enrico Baldi4Simone Savastano5Andrea Cortegiani6Mariachiara Ippolito7Sara Accetta8Alessandra Gargano9Camilla Metelmann10Bibiana Metelmann11Carlos Ramon Hölzing12Julian Ganter13Michael Patrick Müller14Claudio Benvenuti15Stefania Tomola16Pierangelo Pinetti17Pier Luigi Ingrassia18Francesca Dalia Faraci19Angelo Auricchio20Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland; Fondazione Ticino Cuore, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland; Corresponding author at: Department of Cardiology, Cardiocentro Ticino Institute-EOC, Via Tesserete 48, 6900 Lugano, Switzerland.University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Department of Innovative Technologies (DTI) – MeDiTech Institute, Lugano, SwitzerlandFondazione Ticino Cuore, Lugano, SwitzerlandDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Cardiac Arrest and Resuscitation Science Research Team (RESTART), Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Cardiac Arrest and Resuscitation Science Research Team (RESTART), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Pavia nel Cuore, Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Cardiac Arrest and Resuscitation Science Research Team (RESTART), Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDepartment of Anesthesia, Analgesia, Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, Palermo, Italy; Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, ItalyDepartment of Anesthesia, Analgesia, Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, Palermo, Italy; Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, ItalyDepartment of Anesthesia, Analgesia, Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, Palermo, ItalyDepartment of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, ItalyDepartment of Anaesthesia, Intensive Care Medicine, Emergency Medicine and Pain Medicine, University Medicine Greifswald, GermanyDepartment of Anaesthesia, Intensive Care Medicine, Emergency Medicine and Pain Medicine, University Medicine Greifswald, GermanyDepartment of Anaesthesia, Intensive Care Medicine, Emergency Medicine and Pain Medicine, University Medicine Greifswald, GermanyDepartment of Anaesthesiology and Critical Care, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, GermanyDepartment of Anaesthesiology, Intensive Care and Emergency Medicine, St. Josefs Hospital, Freiburg, GermanyFondazione Ticino Cuore, Lugano, SwitzerlandCentro di Simulazione (CeSi), Centro Professionale Sociosanitario Medico-Tecnico di Lugano, SwitzerlandCentro di Simulazione (CeSi), Centro Professionale Sociosanitario Medico-Tecnico di Lugano, SwitzerlandCentro di Simulazione (CeSi), Centro Professionale Sociosanitario Medico-Tecnico di Lugano, SwitzerlandUniversity of Applied Sciences and Arts of Southern Switzerland (SUPSI), Department of Innovative Technologies (DTI) – MeDiTech Institute, Lugano, SwitzerlandCardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland; Fondazione Ticino Cuore, Lugano, SwitzerlandBackground and trial design: Outcomes of out-of-hospital cardiac arrest vary significantly, often due to the quality of cardiopulmonary resuscitation (CPR) provided. Automated real-time feedback devices have been explored to enhance CPR skills, but few devices currently ensure proper chest recoil. This study aimed to assess whether a double-click metronome could improve chest compressions (CC) metrics and particularly CC release velocity (CCRV) during CPR manikin simulation. Methods: We developed and tested a double-click metronome for CPR, where the first click signals the compression and the second click marks the end of chest release. We performed a multicenter non-blinded, randomized, controlled trial including volunteers with different levels of CPR expertise. Three CC metrics—depth, rate, and CCRV—were measured using an automated external defibrillator equipped with pads for CPR quality analysis. Results: 503 volunteers participated in the study, with 54% being male and a mean age of 34 ± 12 years. The median CCRV and CC depth achieved with the double-click metronome were significantly higher compared to the standard metronome (median difference 6 mm/s, IQR-15.2, 28.5, +1.5%, p < 0.001; median difference 0.1 cm, +2.5%, IQR −0.1, 0.4, p < 0.001). The double-click metronome led to significant improvements in CC depth and CCRV across all volunteer categories, with the greater effect observed in first responders and in non-specialized healthcare personnel. Conclusions: Compared to a standard metronome, the double-click metronome significantly enhances CPR quality. If further validated in real resuscitations, this new audio prompt could be a valuable tool for integration into devices designed for out-of-hospital cardiac arrest resuscitation, as well as a training tool to improve CPR quality.http://www.sciencedirect.com/science/article/pii/S2666520425000049Out-of-hospital cardiac arrestCardiopulmonary resuscitationAudio promptCPR quality |
| spellingShingle | Maria Luce Caputo Giuliana Monachino Ruggero Cresta Alessia Currao Enrico Baldi Simone Savastano Andrea Cortegiani Mariachiara Ippolito Sara Accetta Alessandra Gargano Camilla Metelmann Bibiana Metelmann Carlos Ramon Hölzing Julian Ganter Michael Patrick Müller Claudio Benvenuti Stefania Tomola Pierangelo Pinetti Pier Luigi Ingrassia Francesca Dalia Faraci Angelo Auricchio Release velocity ImprovemenT with a new Metronome guIding chest COmpressions: The RITMICO simulation study Resuscitation Plus Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Audio prompt CPR quality |
| title | Release velocity ImprovemenT with a new Metronome guIding chest COmpressions: The RITMICO simulation study |
| title_full | Release velocity ImprovemenT with a new Metronome guIding chest COmpressions: The RITMICO simulation study |
| title_fullStr | Release velocity ImprovemenT with a new Metronome guIding chest COmpressions: The RITMICO simulation study |
| title_full_unstemmed | Release velocity ImprovemenT with a new Metronome guIding chest COmpressions: The RITMICO simulation study |
| title_short | Release velocity ImprovemenT with a new Metronome guIding chest COmpressions: The RITMICO simulation study |
| title_sort | release velocity improvement with a new metronome guiding chest compressions the ritmico simulation study |
| topic | Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Audio prompt CPR quality |
| url | http://www.sciencedirect.com/science/article/pii/S2666520425000049 |
| work_keys_str_mv | AT marialucecaputo releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT giulianamonachino releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT ruggerocresta releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT alessiacurrao releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT enricobaldi releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT simonesavastano releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT andreacortegiani releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT mariachiaraippolito releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT saraaccetta releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT alessandragargano releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT camillametelmann releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT bibianametelmann releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT carlosramonholzing releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT julianganter releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT michaelpatrickmuller releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT claudiobenvenuti releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT stefaniatomola releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT pierangelopinetti releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT pierluigiingrassia releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT francescadaliafaraci releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy AT angeloauricchio releasevelocityimprovementwithanewmetronomeguidingchestcompressionstheritmicosimulationstudy |