The Impact of Real-Time CPR Feedback Devices on Chest Compression Quality and Neurologic Outcomes in Pediatric Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis

The Impact of Real-Time CPR Feedback Devices on Chest Compression Quality and Neurologic Outcomes in Pediatric Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review The Impact of Real-Time CPR Feedback Devices on Chest Compression Quality and Neurologic Outcomes in Pediatric Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis Aydin Mahmoud Alilou, Jafar Khani, Reza Rostami, Milad Chinehkesh, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8180154/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The impact of real-time CPR feedback devices on outcomes in pediatric out-of-hospital cardiac arrest (OHCA) remains inadequately synthesized. This systematic review and meta-analysis aimed to evaluate the effect of these devices on chest compression quality and neurologic outcomes in this population. Methods We searched seven electronic databases and clinical trial registries from January 2015 to December 2024 for randomized controlled trials and observational studies comparing real-time CPR feedback devices to standard CPR in pediatric OHCA. Study selection, data extraction, and risk-of-bias assessment (using RoB 2 and ROBINS-I tools) were conducted independently by two reviewers. Meta-analyses were performed using random-effects models, and the certainty of evidence was assessed with the GRADE framework. Results From 957 identified records, 11 studies involving 3,448 patients were included in the meta-analysis. Pooled analysis demonstrated that feedback devices significantly improved the rate of good neurological outcome (Cerebral Performance Category 1–2) (Risk Ratio [RR] 1.32, 95% CI 1.12–1.56; I²=45%; moderate certainty). Significant benefits were also observed for return of spontaneous circulation (RR 1.24, 95% CI 1.08–1.43), survival to hospital discharge (RR 1.18, 95% CI 1.01–1.38), and chest compression depth (Mean Difference 3.2 mm, 95% CI 1.8–4.6). Subgroup analyses revealed greater effectiveness for children aged 1–12 years compared to infants, and for audiovisual devices compared to sensor-based systems. Conclusion Real-time CPR feedback devices significantly improve neurological outcomes, survival, and CPR quality in pediatric OHCA. These findings support the implementation of this technology, particularly audiovisual feedback systems, in pediatric resuscitation protocols. Pediatric Out-of-Hospital Cardiac Arrest Cardiopulmonary Resuscitation Real-Time Feedback Systems Chest Compression Quality Neurological Outcome Meta-Analysis Advanced Life Support Resuscitation Technology Cerebral Performance Category Health Technology Assessment Full Text Additional Declarations No competing interests reported. Supplementary Files SUPP.FILE1.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8180154","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":549414963,"identity":"442b44e9-463a-43fa-82ba-6730f2a4c95d","order_by":0,"name":"Aydin Mahmoud 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Meta-Analysis","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Pediatric Out-of-Hospital Cardiac Arrest, Cardiopulmonary Resuscitation, Real-Time Feedback Systems, Chest Compression Quality, Neurological Outcome, Meta-Analysis, Advanced Life Support, Resuscitation Technology, Cerebral Performance Category, Health Technology Assessment","lastPublishedDoi":"10.21203/rs.3.rs-8180154/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8180154/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe impact of real-time CPR feedback devices on outcomes in pediatric out-of-hospital cardiac arrest (OHCA) remains inadequately synthesized. This systematic review and meta-analysis aimed to evaluate the effect of these devices on chest compression quality and neurologic outcomes in this population.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe searched seven electronic databases and clinical trial registries from January 2015 to December 2024 for randomized controlled trials and observational studies comparing real-time CPR feedback devices to standard CPR in pediatric OHCA. Study selection, data extraction, and risk-of-bias assessment (using RoB 2 and ROBINS-I tools) were conducted independently by two reviewers. Meta-analyses were performed using random-effects models, and the certainty of evidence was assessed with the GRADE framework.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eFrom 957 identified records, 11 studies involving 3,448 patients were included in the meta-analysis. Pooled analysis demonstrated that feedback devices significantly improved the rate of good neurological outcome (Cerebral Performance Category 1\u0026ndash;2) (Risk Ratio [RR] 1.32, 95% CI 1.12\u0026ndash;1.56; I\u0026sup2;=45%; moderate certainty). Significant benefits were also observed for return of spontaneous circulation (RR 1.24, 95% CI 1.08\u0026ndash;1.43), survival to hospital discharge (RR 1.18, 95% CI 1.01\u0026ndash;1.38), and chest compression depth (Mean Difference 3.2 mm, 95% CI 1.8\u0026ndash;4.6). Subgroup analyses revealed greater effectiveness for children aged 1\u0026ndash;12 years compared to infants, and for audiovisual devices compared to sensor-based systems.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eReal-time CPR feedback devices significantly improve neurological outcomes, survival, and CPR quality in pediatric OHCA. These findings support the implementation of this technology, particularly audiovisual feedback systems, in pediatric resuscitation protocols.\u003c/p\u003e","manuscriptTitle":"The Impact of Real-Time CPR Feedback Devices on Chest Compression Quality and Neurologic Outcomes in Pediatric Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-25 18:22:47","doi":"10.21203/rs.3.rs-8180154/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4f383a1b-3a2a-435c-aaec-a1e8d9a31040","owner":[],"postedDate":"November 25th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-07T09:40:04+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-25 18:22:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8180154","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8180154","identity":"rs-8180154","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}