Document Detail


Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study.
MedLine Citation:
PMID:  17368153     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mouth-to-mouth ventilation is a barrier to bystanders doing cardiopulmonary resuscitation (CPR), but few clinical studies have investigated the efficacy of bystander resuscitation by chest compressions without mouth-to-mouth ventilation (cardiac-only resuscitation). METHODS: We did a prospective, multicentre, observational study of patients who had out-of-hospital cardiac arrest. On arrival at the scene, paramedics assessed the technique of bystander resuscitation. The primary endpoint was favourable neurological outcome 30 days after cardiac arrest. FINDINGS: 4068 adult patients who had out-of-hospital cardiac arrest witnessed by bystanders were included; 439 (11%) received cardiac-only resuscitation from bystanders, 712 (18%) conventional CPR, and 2917 (72%) received no bystander CPR. Any resuscitation attempt was associated with a higher proportion having favourable neurological outcomes than no resuscitation (5.0%vs 2.2%, p<0.0001). Cardiac-only resuscitation resulted in a higher proportion of patients with favourable neurological outcomes than conventional CPR in patients with apnoea (6.2%vs 3.1%; p=0.0195), with shockable rhythm (19.4%vs 11.2%, p=0.041), and with resuscitation that started within 4 min of arrest (10.1%vs 5.1%, p=0.0221). However, there was no evidence for any benefit from the addition of mouth-to-mouth ventilation in any subgroup. The adjusted odds ratio for a favourable neurological outcome after cardiac-only resuscitation was 2.2 (95% CI 1.2-4.2) in patients who received any resuscitation from bystanders. INTERPRETATION: Cardiac-only resuscitation by bystanders is the preferable approach to resuscitation for adult patients with witnessed out-of-hospital cardiac arrest, especially those with apnoea, shockable rhythm, or short periods of untreated arrest.
Authors:
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  369     ISSN:  1474-547X     ISO Abbreviation:  Lancet     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-19     Completed Date:  2007-04-12     Revised Date:  2008-10-20    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  920-6     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation / methods*,  statistics & numerical data
Caregivers
Cohort Studies
Female
Follow-Up Studies
Heart Arrest / complications,  therapy*
Heart Massage / methods*,  statistics & numerical data
Humans
Logistic Models
Male
Middle Aged
Nervous System Diseases / etiology
Observation
Prospective Studies
Sex Distribution
Survival Analysis
Treatment Outcome
Comments/Corrections
Comment In:
Lancet. 2007 Jun 9;369(9577):1924-5; author reply 1925   [PMID:  17560436 ]
Lancet. 2007 Jun 9;369(9577):1925; author reply 1925   [PMID:  17560439 ]
Crit Care. 2008;12(2):302   [PMID:  18341712 ]
Lancet. 2007 Mar 17;369(9565):882-4   [PMID:  17368131 ]
Lancet. 2007 Jun 9;369(9577):1924; author reply 1925   [PMID:  17560437 ]
Lancet. 2007 Jun 9;369(9577):1926   [PMID:  17560440 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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