Compression-only cardiopulmonary resuscitation beats standard CPR

Cardiopulmonary resuscitation or CPR indicated to revive or keep alive patients who experience cardiac arrest or cardiac infarction (heart attack) conventionally consists of two parts, chest compression and mouth-to-mouth rescue-breathing. But two studies confirm that the rescue-breathing part does not help.

The standard or recommended CPR includes 30 chest compressions and two mouth-to- mouth breaths. Chest compression requires pressing the patient's chest down at least one and a half inches within less than one second before releasing.

One study of about 2000 patients led by Thomas D. Rea, M.D. at the University of Washington and colleagues showed that chest compression only cardiopulmonary resuscitation saved 12.5% of patients who were able to live to hospital discharge after being resuscitated while the conventional CPR saved 11%.  The study was published in the July 29, 2010 issue of the New England Journal of Medicine.

In the same issue, another study led by Leif Svensson, M.D., Ph.D. at Karolinska Institutet in Sweden and colleagues also found that chest compression alone helped 8.7% of patients to survive for 30 days or more while the standard CPR helped just 7% of patients.

Cardiopulmonary resuscitation is intended to create a type of artificial respiration to keep the patient alive while waiting for medical processionals to arrive.

Early studies have already demonstrated that mouth-to-mouth rescue breathing is not necessary.

A Japanese study reported on March 17, 2007 in The Lancet revealed that the so-called rescue breathing can actually do more harm than good, potentially increasing the risk of brain damage in the survivors.

In the study, Ken Nagao MD of Surugadai Nihon University Hospital in Tokyo, Japan and colleagues examined data from 4,068 adults who had an out-of-hospital cardiac arrest.

Among more than 70 patients, the researchers found the percentage surviving with a favorable neurological outcome to be 19.4 percent among those receiving chest compressions without mouth-to-mouth ventilation. 

In contrast, the favorable neurological survival rate in those who received traditional or recommended CPR was only 11.2 percent.

Experts explained that time is critical when it comes to the rescuing of a patient who suffers cardiac arrest.   Mouth-to-mouth ventilation is not only unnecessary in those who suffer cardiac arrest, but also wastes time and disrupts chest compression, which should be continuous to increase the odds of survival.

Compression-only cardiopulmonary resuscitation is evidently at least effective as the conventional in rescuing patients who suffer cardiac arrest or cardiac infarction.

Some medical organizations like University of Arizona Sarver Heart Center encourage people to do compression-only CPR. They say the procedure is safe, easy and legal.

David Liu