Faculty Collaboration Database

The impact of increased chest compression fraction on return of spontaneous circulation for out-of-hospital cardiac arrest patients not in ventricular fibrillation. Resuscitation 2011 Dec;82(12):1501-7

Date

07/19/2011

Pubmed ID

21763252

Pubmed Central ID

PMC3215827

DOI

10.1016/j.resuscitation.2011.07.011

Scopus ID

2-s2.0-80855138133 (requires institutional sign-in at Scopus site)   221 Citations

Abstract

OBJECTIVE: Greater chest compression fraction (CCF, or proportion of CPR time spent providing compressions) is associated with better survival for out-of-hospital cardiac arrest (OOHCA) patients in ventricular fibrillation (VF). We evaluated the effect of CCF on return of spontaneous circulation (ROSC) in OOHCA patients with non-VF ECG rhythms in the Resuscitation Outcomes Consortium Epistry.

METHODS: This prospective cohort study included OOHCA patients if: not witnessed by EMS, no automated external defibrillator (AED) shock prior to EMS arrival, received >1 min of CPR with CPR process measures available, and initial non-VF rhythm. We reviewed the first 5 min of electronic CPR records following defibrillator application, measuring the proportion of compressions/min during the resuscitation.

RESULTS: Demographics of 2103 adult patients from 10 U.S. and Canadian centers were: mean age 67.8; male 61.2%; public location 10.6%; bystander witnessed 32.9%; bystander CPR 35.4%; median interval from 911 to defibrillator turned on 8 min:27 s; initial rhythm asystole 64.0%, PEA 28.0%, other non-shockable 8.0%; median compression rate 110/min; median CCF 71%; ROSC 24.2%; survival to hospital discharge 2.0%. The estimated linear effect on adjusted odds ratio with 95% confidence interval (OR; 95%CI) of ROSC for each 10% increase in CCF was (1.05; 0.99, 1.12). Adjusted (OR; 95%CI) of ROSC for each CCF category were: 0-40% (reference group); 41-60% (1.14; 0.72, 1.81); 61-80% (1.42; 0.92, 2.20); and 81-100% (1.48; 0.94, 2.32).

CONCLUSIONS: This is the first study to demonstrate that increased CCF among non-VF OOHCA patients is associated with a trend toward increased likelihood of ROSC.

Author List

Vaillancourt C, Everson-Stewart S, Christenson J, Andrusiek D, Powell J, Nichol G, Cheskes S, Aufderheide TP, Berg R, Stiell IG, Resuscitation Outcomes Consortium Investigators

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Blood Circulation
Canada
Cardiopulmonary Resuscitation
Emergency Medical Services
Female
Follow-Up Studies
Humans
Male
Odds Ratio
Out-of-Hospital Cardiac Arrest
Prospective Studies
Recovery of Function
Survival Rate
Thorax
Time Factors
United States
Ventricular Fibrillation