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

TY - JOUR

T1 - Associations of manual defibrillator compared to automated external defibrillator usage with defibrillation and resuscitation quality during in-hospital cardiac arrest

AU - Nettinger, Moritz

AU - Wittig, Johannes

AU - Riis, Dung Nguyen

AU - Løfgren, Bo

AU - Lauridsen, Kasper G.

N1 - Publisher Copyright: © 2025 The Author(s)

PY - 2025/7

Y1 - 2025/7

N2 - Background: 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. Methods: 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. Results: 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. Conclusion: 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.

AB - Background: 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. Methods: 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. Results: 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. Conclusion: 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.

KW - Automated External Defibrillator

KW - Cardiopulmonary Resuscitation

KW - Defibrillation

KW - In-hospital Cardiac Arrest

KW - Quality of Care

UR - http://www.scopus.com/inward/record.url?scp=105004764581&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2025.110619

DO - 10.1016/j.resuscitation.2025.110619

M3 - Journal article

C2 - 40280355

AN - SCOPUS:105004764581

SN - 0300-9572

VL - 212

JO - Resuscitation

JF - Resuscitation

M1 - 110619

ER -