| Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study. | |
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MedLine Citation:
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PMID: 17368153 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Lancet Volume: 369 ISSN: 1474-547X ISO Abbreviation: Lancet Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-03-19 Completed Date: 2007-04-12 Revised Date: 2008-10-20 |
Medline Journal Info:
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Nlm Unique ID: 2985213R Medline TA: Lancet Country: England |
Other Details:
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Languages: eng Pagination: 920-6 Citation Subset: AIM; IM |
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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 ] |
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