Effect of real-time feedback on patient's outcomes and survival after cardiac arrest: A systematic review and meta-analysis.

Purpose: This study investigated the effect of real-time feedback on the restoration of spontaneous circulation, survival to hospital discharge, and favorable functional outcomes after hospital discharge.

Methods: PubMed, ScienceDirect, and China National Knowledge Infrastructure databases were searched to screen the relevant studies up to June 2020. Fixed-effects or random-effects model were used to calculate the pooled estimates of relative ratios (RRs) with 95% confidence intervals (CIs).

Results: Ten relevant articles on 4281 cardiac arrest cases were identified. The pooled analyses indicated that real-time feedback did not improve restoration of spontaneous circulation (RR: 1.13, 95% CI: 0.92-1.37, and P = .24; I2 = 81%; P < .001), survival to hospital discharge (RR: 1.27, 95% CI: 0.90-1.79, and P = .18; I2 = 74%; P < .001), and favorable neurological outcomes after hospital discharge (RR: 1.09, 95% CI: 0.87-1.38; P = .45; I2 = 16%; P = .31). The predefined subgroup analysis showed that the sample size and arrest location may be the origin of heterogeneity. Begg's and Egger's tests showed no publication bias, and sensitivity analysis indicated that the results were stable.

Conclusion: The meta-analysis had shown that the implementation of real-time audiovisual feedback was not associated with improved restoration of spontaneous circulation, increased survival, and favorable functional outcomes after hospital discharge.