Document Detail


Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation.
MedLine Citation:
PMID:  19752324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Quality cardiopulmonary resuscitation contributes to cardiac arrest survival. The proportion of time in which chest compressions are performed in each minute of cardiopulmonary resuscitation is an important modifiable aspect of quality cardiopulmonary resuscitation. We sought to estimate the effect of an increasing proportion of time spent performing chest compressions during cardiac arrest on survival to hospital discharge in patients with out-of-hospital ventricular fibrillation or pulseless ventricular tachycardia.
METHODS AND RESULTS: This is a prospective observational cohort study of adult patients from the Resuscitation Outcomes Consortium Cardiac Arrest Epistry with confirmed ventricular fibrillation or ventricular tachycardia, no defibrillation before emergency medical services arrival, electronically recorded cardiopulmonary resuscitation before the first shock, and a confirmed outcome. Patients were followed up to discharge from the hospital or death. Of the 506 cases, the mean age was 64 years, 80% were male, 71% were witnessed by a bystander, 51% received bystander cardiopulmonary resuscitation, 34% occurred in a public location, and 23% survived. After adjustment for age, gender, location, bystander cardiopulmonary resuscitation, bystander witness status, and response time, the odds ratios of surviving to hospital discharge in the 2 highest categories of chest compression fraction compared with the reference category were 3.01 (95% confidence interval 1.37 to 6.58) and 2.33 (95% confidence interval 0.96 to 5.63). The estimated adjusted linear effect on odds ratio of survival for a 10% change in chest compression fraction was 1.11 (95% confidence interval 1.01 to 1.21).
CONCLUSIONS: An increased chest compression fraction is independently predictive of better survival in patients who experience a prehospital ventricular fibrillation/tachycardia cardiac arrest.
Authors:
Jim Christenson; Douglas Andrusiek; Siobhan Everson-Stewart; Peter Kudenchuk; David Hostler; Judy Powell; Clifton W Callaway; Dan Bishop; Christian Vaillancourt; Dan Davis; Tom P Aufderheide; Ahamed Idris; John A Stouffer; Ian Stiell; Robert Berg;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-09-14
Journal Detail:
Title:  Circulation     Volume:  120     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-29     Completed Date:  2009-10-29     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1241-7     Citation Subset:  AIM; IM    
Affiliation:
MSc, Emergency and Health Services Commission of British Columbia, 302-2955 Virtual Way, Vancouver, British Columbia, Canada V5M 4X6.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiopulmonary Resuscitation / methods,  standards,  statistics & numerical data*
Cohort Studies
Databases, Factual
Electric Countershock / statistics & numerical data
Emergency Medical Services / statistics & numerical data*
Female
Heart Arrest / mortality,  therapy
Humans
Male
Middle Aged
Predictive Value of Tests
Tachycardia, Ventricular / mortality,  therapy
Ventricular Fibrillation / mortality*,  therapy*
Grant Support
ID/Acronym/Agency:
5U01 HL077863/HL/NHLBI NIH HHS; HL077865/HL/NHLBI NIH HHS; HL077866/HL/NHLBI NIH HHS; HL077867/HL/NHLBI NIH HHS; HL077871/HL/NHLBI NIH HHS; HL077872/HL/NHLBI NIH HHS; HL077873/HL/NHLBI NIH HHS; HL077881/HL/NHLBI NIH HHS; HL077885/HL/NHLBI NIH HHS; HL077887/HL/NHLBI NIH HHS; HL077908/HL/NHLBI NIH HHS; U01 HL077863-01/HL/NHLBI NIH HHS; U01 HL077863-02/HL/NHLBI NIH HHS; U01 HL077863-02S1/HL/NHLBI NIH HHS; U01 HL077863-03/HL/NHLBI NIH HHS; U01 HL077863-03S1/HL/NHLBI NIH HHS; U01 HL077863-04/HL/NHLBI NIH HHS; U01 HL077863-05/HL/NHLBI NIH HHS; U01 HL077866-01/HL/NHLBI NIH HHS; U01 HL077866-02/HL/NHLBI NIH HHS; U01 HL077866-03/HL/NHLBI NIH HHS; U01 HL077866-04/HL/NHLBI NIH HHS; U01 HL077866-05/HL/NHLBI NIH HHS; U01 HL077867-01/HL/NHLBI NIH HHS; U01 HL077867-02/HL/NHLBI NIH HHS; U01 HL077867-03/HL/NHLBI NIH HHS; U01 HL077867-04/HL/NHLBI NIH HHS; U01 HL077867-05/HL/NHLBI NIH HHS; U01 HL077871-01/HL/NHLBI NIH HHS; U01 HL077871-02/HL/NHLBI NIH HHS; U01 HL077871-03/HL/NHLBI NIH HHS; U01 HL077871-04/HL/NHLBI NIH HHS; U01 HL077871-05/HL/NHLBI NIH HHS; U01 HL077872-01/HL/NHLBI NIH HHS; U01 HL077872-02/HL/NHLBI NIH HHS; U01 HL077872-03/HL/NHLBI NIH HHS; U01 HL077872-04/HL/NHLBI NIH HHS; U01 HL077872-05/HL/NHLBI NIH HHS; U01 HL077873-01/HL/NHLBI NIH HHS; U01 HL077873-02/HL/NHLBI NIH HHS; U01 HL077873-03/HL/NHLBI NIH HHS; U01 HL077873-04/HL/NHLBI NIH HHS; U01 HL077873-05/HL/NHLBI NIH HHS; U01 HL077881-01/HL/NHLBI NIH HHS; U01 HL077881-02/HL/NHLBI NIH HHS; U01 HL077881-03/HL/NHLBI NIH HHS; U01 HL077881-04/HL/NHLBI NIH HHS; U01 HL077881-05/HL/NHLBI NIH HHS; U01 HL077885-01/HL/NHLBI NIH HHS; U01 HL077885-02/HL/NHLBI NIH HHS; U01 HL077885-03/HL/NHLBI NIH HHS; U01 HL077885-04/HL/NHLBI NIH HHS; U01 HL077885-05/HL/NHLBI NIH HHS; U01 HL077887-01/HL/NHLBI NIH HHS; U01 HL077887-02/HL/NHLBI NIH HHS; U01 HL077887-03/HL/NHLBI NIH HHS; U01 HL077887-04/HL/NHLBI NIH HHS; U01 HL077887-05/HL/NHLBI NIH HHS; U01 HL077908-03/HL/NHLBI NIH HHS; U01 HL077908-04/HL/NHLBI NIH HHS; U01 HL077908-05/HL/NHLBI NIH HHS

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