Better outcomes with conventional CPR
February 3, 2011 by Cliff
Filed under All Updates, EMS, Resus
A very large nationwide Japanese observational study examined outcomes in out-of-hospital cardiac arrest patients who received CPR from lay rescuers. They compared conventional CPR (with mouth-to-mouth and chest compressions) with compression-only CPR. Over 40 000 patients were included.
Conventional CPR was associated with better outcomes than chest compression only CPR, for both one month survival (adjusted odds ratio 1.17, 95% confidence interval 1.06 to 1.29) and neurologically favourable one month survival (1.17, 1.01 to 1.35). Neurologically favourable one month survival decreased with increasing age and with delays of up to 10 minutes in starting CPR for both conventional and chest compression only CPR. The benefit of conventional CPR over chest compression only CPR was significantly greater in younger people in non-cardiac cases (P=0.025) and with a delay in start of CPR after the event was witnessed in non-cardiac cases (P=0.015) and all cases combined (P=0.037).
The authors conclude that conventional CPR is associated with better outcomes than chest compression only CPR for selected patients with out of hospital cardiopulmonary arrest, such as those with arrests of non-cardiac origin and younger people, and people in whom there was delay in the start of CPR.
Outcomes of chest compression only CPR versus conventional CPR conducted by lay people in patients with out of hospital cardiopulmonary arrest witnessed by bystanders: nationwide population based observational study
BMJ 2011; 2011; 342:c7106 Full Text
Has anyone been advocating compression-only CPR for non-cardiac causes of arrest?
Everything I have read has stated that compression-only CPR is for arrests of suspected cardiac causes.
It is interesting that the 40-59 year olds had better outcomes with compression-only CPR than with conventional CPR for non-cardiac origin arrests.
The same age group had worse outcomes with compression-only CPR than with conventional CPR for cardiac origin arrests.
[...] starts off with a paper suggesting we shouldn’t give up on conventional CPRall together just yet… and then tells us that there may be some benefit from uber-invasive [...]