The use of a metronome during cardiopulmonary resuscitation in the emergency room of a university hospital.
Renata Maria de Oliveira Botelho, Cássia Regina Vancini Campanharo, Maria Carolina Barbosa Teixeira Lopes and 3 others
PMID 27878221WHAT IT FOUND
In adult in-hospital cardiac arrest, guiding chest compressions with a metronome at 110 beats per minute did not change return of circulation or death compared with usual CPR.
It kept compressions in range but did not improve survival.
Key findings
01There was no statistically significant difference between the metronome group and the control group in return of spontaneous circulation or death.
02The metronome was set at 110 beats per minute and kept chest compressions within the recommended range, but it did not influence survival rate.
03Return of spontaneous circulation occurred in 28 of 51 patients in the metronome group and 36 of 60 patients in the control group, with no significant difference.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in one hospital emergency room and analysed a small sample of 111 patients. The control group came from 2011 and the metronome group from 2014, so changes over time, staffing, or practice could affect the comparison. The researchers could not verify the depth of chest compressions, so the study cannot show whether the metronome improved overall compression quality. The metronome was tested during conventional CPR, so the contribution of any single component cannot be separated. The paper says 285 adults received CPR but the analysed sample was 111 patients, so the relationship between the larger cohort and the compared groups is unclear.
The easy way to misread this
Do not conclude that a metronome improves survival after cardiac arrest. It kept compressions at 110 beats per minute, but return of circulation and death did not differ significantly from usual CPR. The metronome was added to conventional CPR, so the effect of any single component cannot be isolated.