More Chest Compressions in CPR May Improve Survival

Researchers urge changes to resuscitation practices to maximize chest compression in CPR

16 sept 2009-- The more that emergency personnel perform chest compression during cardiopulmonary resuscitation (CPR) of a patient in cardiac arrest, the greater the odds of patient survival, according to a study published online Sept. 14 in Circulation.

Jim Christenson, M.D., of the University of British Columbia in Vancouver, Canada, and colleagues studied a cohort of 506 patients who suffered out-of-hospital cardiac arrest due to ventricular fibrillation or ventricular tachycardia and did not undergo defibrillation before electronically-monitored CPR was performed. The researchers assessed the relationship between the fraction of time spent on chest compression (CCF) and patient survival to hospital discharge.

Generally, the researchers found that the adjusted odds ratio for survival increased with increased CCF. For 0 to 20 percent CCF, (reference); for 21 to 40 percent CCF, odds ratio, 2.27; for 41 to 60 percent CCF, odds ratio, 2.39; for 61 to 80 percent CCF, odds ratio, 3.01; and for 81 to 100 percent CCF, odds ratio, 2.33. The researchers attributed the drop in odds ratio in the highest CCF category to a plateau effect above 80 percent CCF or a patient group in which there was less likelihood of survival and more extreme resuscitation efforts.

"These data strongly support the contention that more time spent performing chest compressions in the early phase of resuscitation substantially affects survival to hospital discharge. Implementation of strategies to alter resuscitation practices to maximize chest compression fraction are likely to result in a real and sustainable increase in survival from cardiac arrest," the authors write.

Abstract
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