Modified Protocol Improves Cardiac Arrest Survival

Optimizing chest compressions increases return of spontaneous circulation

06 may 2009-- Modified guidelines on the out-of-hospital management of cardiac arrest patients that optimizes compressions and reduces disruption improves survival rates, according to a study published online on May 4 in Circulation.

Alex G. Garza, M.D., of Georgetown University School of Medicine in Washington, D.C., and colleagues analyzed data on survival rates for 1,097 adult primary ventricular fibrillation and pulseless ventricular tachycardia cardiac arrest cases admitted in the 36 months prior to the introduction of the revised resuscitation protocol, and compared results with those of 339 cases in the 12 months after the protocol was introduced. The protocol included mandatory pre-shock chest compressions at an increased rate of 50:2, delayed intubation, and, where available, strict use of manual defibrillators.

The survival rate of out-of-hospital arrest of presumed primary cardiac origin rose from 7.5 percent before the revised protocol was introduced to 13.9 percent afterwards, the investigators discovered. In the subset of witnessed cardiac arrest patients with initial rhythm of ventricular fibrillation there was an increase in return to spontaneous circulation from 37.8 percent before the revised protocol to 59.6 percent afterwards, the researchers noted.

"Further studies are warranted to look at the impact of the new 2005 American Heart Association guidelines on survival, and further work is needed to benchmark best practices in cardiac arrest," the authors conclude."

Abstract
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