Chest-Compression-Only CPR Should Be Recommended

Emergency medical services shouldn't advise bystanders to perform CPR with mouth-to-mouth

16 oct 2010-- Chest-compression-only cardiopulmonary resuscitation (CPR) should be recommended by emergency medical services to bystanders caring for individuals experiencing out-of-hospital cardiac arrest rather than standard CPR with mouth-to-mouth, according to research published online Oct. 15 in The Lancet.

Michael Hupfl, M.D., of Medical University of Vienna in Austria, and colleagues systematically reviewed studies in which chest-compression-only bystander CPR was compared with standard bystander CPR for adult patients with out-of-hospital cardiac arrest. The investigators completed a primary meta-analysis in which patients were randomized to receive one of the two CPR techniques, as well as a secondary meta-analysis of observational cohort studies.

In the primary meta-analysis, using pooled data from three randomized trials, the investigators found that chest-compression-only CPR was associated with an improved chance of survival as compared with standard CPR (14 percent versus 12 percent). The data also revealed that the absolute increase in survival was 2.4 percent and the number needed to treat was 41. No difference was found between chest-compression-only CPR and standard CPR in the secondary meta-analysis of seven observational cohort studies.

"Our findings support the idea that emergency medical services dispatch should instruct bystanders to focus on chest-compression-only CPR in adults with out-of-hospital cardiac arrest," the authors write. "However, whether chest-compression-only CPR should be recommended for unassisted lay bystander CPR is unclear."

One author disclosed financial ties to Roche Diagnostics and Gerson Lehrman Group, and another disclosed financial ties to St John's Ambulance Service in Vienna and Novo Nordisk.

Abstract
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