Compression Only Cardiopulmonary Resuscitation Saves More Cardiac Arrest Patients
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A new study in the Oct 2010 issue of Journal of American Medical Association suggests compression-only cardiopulmonary resuscitation may save more lives from sudden cardiac arrest than conventional CPR or no CPR.
The study found patients who suffered out-of hospital cardiac arrest and received compression only cardiopulmonary resuscitation had a better chance of surviving to hospital discharge than cardiac arrest patients who received conventional CPR or no CPR.
Specifically, the survival rate for those receiving compression only cardiopulmonary resuscitation was 13.3 percent compared to 5.2 percent for those who received no CPR from bystanders and 7.8 percent for cardiac arrest patients given conventional cardiopulmonary resuscitation.
Sudden cardiac arrest is a condition in which the heart suddenly stops beating. Death is imminent if this condition is not normalized in three to five minutes due to massive brain damage from lack of oxygen.
Cardiac arrest is often times caused by arrhythmias meaning that the heart beats too fast, too slow or with an irregular rhythm. The condition differs from myocardial infarction or heart attack which occurs when blood flow to part of the heart muscle is blocked.
Bentley J. Bobrow, M.D., of the Arizona Department of Health Services, Phoenix, and colleagues studied 4,415 patients ages 18 or older with out-of-hospital cardiac arrest between Jan 2005 and Dec 2009 in Arizona. Of the patients, 2,900 did not receive CPR from bystanders, 666 received conventional CPR while 849 received compression only CPR.
The researchers found compression only CPR was 70 percent more likely than conventional CPR or no CPR to save an individual who experienced cardiac arrest.
An early study led by Jim Christenson, M.D., lead author of the study and clinical professor of emergency medicine at the University of British Columbia, reached a similar conclusion - more chest compressions mean more saved lives during cardiopulmonary resuscitation.
Dr. Christenson reported their study in Sep 2009 in Circulation - Journal of the American Heart Association saying high fraction of chest compression during each minute of cardiopulmonary resuscitation generally resulted in high rates of survival to hospital discharge.
They found when 0 to 20 percent of time was spent on chest compression the survival rate was 12 percent, when the time increased to 61 to 81 percent, the rate increased to 29 percent. However, when the time for chest compression increased to 81 to 100 percent, the rate dropped to 25 percent.
The researchers suggested that in reality, the survival rate when the chest compression time increased more than 81 percent, the survival rate is probably better. The seemingly slightly lower rate may due to the small sample size, they explained.
Chest compression is intended to move blood with oxygen to the heart and the brain to save the brain, which would die in a matter of a few minutes without oxygen, and prepare the heart to start up its heart beat when a shock is given with a defibrillator.
Survival to hospital discharge occurred in 12 percent of patients when CCF was 0 percent to 20 percent. It increased to nearly 29 percent when CCF was 61 percent to 81 percent, but dropped slightly to 25 percent when CCF was 81 percent to 100 percent CCF.
One of the reasons that conventional cardiopulmonary resuscitation does not work as well as the chest compression only CPR is that bystanders are often non-professional; they may waste lots of time on mouth-to-mouth ventilation and leave insufficient time for chest compression.
Overall, the survival rate for cardiac arrest patients who received CPR is generally low. Researchers are seeking to develop a new method to boost the survival rate.
Leslie Geddes, a Purdue University biomedical engineer, developed a new technique for performing CPR that can increases blood flow through the heart by 25 percent over the current CPR.
Geddes' method called "only rhythmic abdominal compression", avoids two risks associated with conventional CPR: first the CPR performer could potentially catch a contagious disease through mouth-to-mouth breathing, and second, the patients may suffer broken ribs. Another advantage is that the new method requires only one rescuer.
The survival rate for current cardiopulmonary resuscitation is anywhere between 5 to 10 percent. But it remains unknown whether the brand new technique could indeed boost the cardiac arrest survival rate.
By David Liu and editing by Rachel Stockton
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