Document Detail

Improved neurological outcome with continuous chest compressions compared with 30:2 compressions-to-ventilations cardiopulmonary resuscitation in a realistic swine model of out-of-hospital cardiac arrest.
MedLine Citation:
PMID:  17998457     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The 2005 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care changed the previous ventilations-to-chest-compression algorithm for bystander cardiopulmonary resuscitation (CPR) from 2 ventilations before each 15 chest compressions (2:15 CPR) to 30 chest compressions before 2 ventilations (30:2 CPR). It was acknowledged in the guidelines that the change was based on a consensus rather than clear evidence. This study was designed to compare 24-hour neurologically normal survival between the initial applications of continuous chest compressions without assisted ventilations with 30:2 CPR in a swine model of witnessed out-of-hospital ventricular fibrillation cardiac arrest. METHODS AND RESULTS: Sixty-four animals underwent 12 minutes of ventricular fibrillation before defibrillation attempts. They were divided into 4 groups, each with increasing durations (3, 4, 5, and 6 minutes, respectively) of untreated ventricular fibrillation before the initiation of bystander resuscitation consisting of either continuous chest compression or 30:2 CPR. After the various untreated ventricular durations plus bystander resuscitation durations, all animals were given the first defibrillation attempt 12 minutes after the induction of ventricular fibrillation, followed by the 2005 guideline-recommended advanced cardiac life support. Neurologically normal survival at 24 hours after resuscitation was observed in 23 of 33 (70%) of the animals in the continuous chest compression groups but in only 13 of 31 (42%) of the 30:2 CPR groups (P=0.025). CONCLUSIONS: In a realistic model of out-of-hospital ventricular fibrillation cardiac arrest, initial bystander administration of continuous chest compressions without assisted ventilations resulted in significantly better 24-hour postresuscitation neurologically normal survival than did the initial bystander administration of 2005 guideline-recommended 30:2 CPR.
Gordon A Ewy; Mathias Zuercher; Ronald W Hilwig; Arthur B Sanders; Robert A Berg; Charles W Otto; Melinda M Hayes; Karl B Kern
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-11-12
Journal Detail:
Title:  Circulation     Volume:  116     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-27     Completed Date:  2008-01-29     Revised Date:  2008-08-01    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2525-30     Citation Subset:  AIM; IM    
University of Arizona Sarver Heart Center, University of Arizona College of Medicine, Tucson AZ 85724, USA.
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MeSH Terms
Cardiopulmonary Resuscitation / methods*,  mortality,  standards
Heart Arrest / complications,  mortality,  therapy*
Heart Massage / methods*,  standards
Models, Animal
Nervous System Diseases / etiology
Practice Guidelines as Topic / standards*
Treatment Outcome
Ventricular Fibrillation / complications,  mortality,  therapy
Comment In:
Circulation. 2008 Jun 17;117(24):e493; author reply e494   [PMID:  18559708 ]
Circulation. 2007 Nov 27;116(22):2514-6   [PMID:  18040035 ]

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