Compression-only CPR saves more lives

Chest compressions alone may be more effective than standard cardiopulmonary resuscitation (CPR) for cardiac arrest patients in out-of-hospital setting, according to a Japanese study.

In the study, 46 percent of patients who received compression-only CPR were alive a month after cardiac arrest compared with 39.9 percent of those who received standard CPR with rescue breathing. Moreover, those who received compression-only CPR were 40.7 percent more likely to preserve brain function (as measured on a 5-point cerebral performance scale) compared with 32.9 percent in those receiving conventional CPR. [Circulation 2012;126:2844-2851]

“The data suggest that compression-only CPR should be the standard and conventional CPR with rescue breathing the option,” said lead investigator Dr. Taku Iwami from the department of preventive services in Kyoto University School of Public Health, Japan.

Iwami and colleagues reviewed the records of 1,376 individuals who had sudden cardiac arrests of presumed cardiac origin over a 5-year period. Each of them received CPR from bystanders followed by shocks using publicly-accessed defibrillators.

Among the study cohort, 37 percent received compression-only CPR while 63 percent received standard CPR. Prior to hospital admission, spontaneous circulation returned in 50.2 percent of patients receiving compression-only CPR and in 40.5 percent of those receiving standard CPR (p<0.001).

“This goes to show that the combination of early defibrillation and compression-only CPR by bystanders is the best way to save lives after sudden cardiac arrests,” the authors said.

Chest compressions alternating with rescue breathing remains the standard for trained rescuers. However, recommendation for untrained rescuers switched to only chest compressions regardless of emergency dispatch assistance in 2010. This was because rescue breathing is difficult to perform and can interrupt chest compressions, said Iwami.

Despite this, many people are still hesitant to perform CPR with rescue ventilation for fear they may do more harm to the patient. What they are not aware of is that chest compressions, even by those who are not trained in conventional CPR, can help a patient maintain blood flow to the heart and brain until a defibrillator gets the heart pumping again.

“We need to encourage chest compression-only CPR and public access defibrillation programs,” Iwami said. “Doing something is better than nothing.”

Dr. Michael Sayre of the University of Washington in Seattle, US, and spokesperson for the American Heart Association, said many people are dying from cardiac arrest because family members and friends are unsure how to help. The findings confirm that hands-on CPR is highly effective and is easy to do, he added.http://www.mims.com/Indonesia/pub/topic/Medical%20Tribune/2013-03/Compression-only%20CPR%20saves%20more%20lives?token=rnp4v0BfyQa5o3iSS1Uv5Ry6TWCP4H8SXzFN8QDJQWvspgHFYCA8hAPu41olpOmW3vr%2fgB8gvkMKWl5SuULZGmQWwSayeXpIXCS0PgyyJYA37UHiZeai7pULdfk67aMbyr4GUpBdzlxkw4CvmSbxxQBuSqfkGE%2bgDS3Mp3ngH19ooURzIC3fBUmjr9T%2fF8KG7W6FpzNyjIGc%2fz8vGlQyPD9%2fZLCzJJGnJNg844f%2b2GA%3d