Associations of manual defibrillator compared to automated external defibrillator usage with defibrillation and resuscitation quality during in-hospital cardiac arrest.

Abstract

Manual Defibrillators and Automated external defibrillators (AEDs) are frequently used during in-hospital cardiac arrest (IHCA), yet comparisons of their performance remain limited. This study aimed to compare the accuracy of rhythm analyses and chest compression pause durations of manual defibrillator and AED usage during IHCA. In this multicenter cohort study, we analysed thoracic impedance data and electrocardiograms from manual defibrillators and AEDs used during IHCA occurring in the Central Denmark Region between April 2019 and March 2024. The primary outcome was the difference in accuracy of rhythm analyses, while secondary outcomes included chest compression pause duration for rhythm analysis and defibrillation. A total of 529 cardiac arrests were analysed, yielding 1715 rhythm analyses from manual defibrillators and 602 AED analyses. The difference in the accuracy of rhythm analyses between a manual defibrillator and an AED was statistically not significant with an adjusted odds ratio of 0.5 (95%-CI: 0.2; 1.3). Manual defibrillator use was associated with 3.2 s (95%-CI: 1.7; 4.9) shorter pauses for rhythm analysis and 7.9 s (95%-CI: 5.9; 9.9) shorter peri-shock pauses. Using manual defibrillators compared to AEDs was not associated with a higher accuracy of rhythm analyses, but with shorter chest compression pause durations for rhythm analysis and shorter peri-shock pauses.