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Resuscitation. 2014 Feb;85(2):182-8. doi: 10.1016/j.resuscitation.2013.10.002. Epub 2013 Oct 12.

Chest compression depth and survival in out-of-hospital cardiac arrest.

Author information

  • 1Department of Emergency Medicine, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, United States. Electronic address: Vadeboncoeur.tyler@mayo.edu.
  • 2Department of Emergency Medicine, University of Arizona, PO Box 245057, 1501 N. Campbell, Tucson, AZ 85724-5057, United States. Electronic address: ustolz@aemrc.arizona.edu.
  • 3Department of Emergency Medicine, The Ohio State University Wexner Medical Center ,760 Prior Hall 376 West 10th Avenue, Columbus, OH, 43210, United States. Electronic address: apanchal@aemrc.arizona.edu.
  • 4ZOLL Medical, 269 Mill Road, Chelmsford, MA 01824, United States. Electronic address: asilver@zoll.com.
  • 5Guardian Medical Transport, 1200 N Beaver Street, Flagstaff, AZ 86001, United States. Electronic address: mark.venuti@nahealth.com.
  • 6Mesa Fire and Medical Department, 13 W First Street, Mesa, AZ 85201, United States. Electronic address: johntobin@arizona.edu.
  • 7Mesa Fire and Medical Department, 13 W First Street, Mesa, AZ 85201, United States. Electronic address: garysmithmd@netscape.net.
  • 8Bureau of Emergency Medical Services, Arizona Department of Health Services, 150 N. 18th Avenue, #540, Phoenix, AZ 85007, United States. Electronic address: martha.nunez@azdhs.gov.
  • 9Arizona State University, Phoenix, AZ, United States. Electronic address: Madalyn821@gmail.com.
  • 10Department of Emergency Medicine, University of Arizona, PO Box 245057, 1501 N. Campbell, Tucson, AZ 85724-5057, United States. Electronic address: dan@aemrc.arizona.edu.
  • 11Bureau of Emergency Medical Services, Arizona Department of Health Services, 150 N. 18th Avenue, #540, Phoenix, AZ 85007, United States; Maricopa Medical Center, Phoenix, AZ, United States; University of Arizona College of Medicine, Phoenix, AZ, United States. Electronic address: bobrowb@azdhs.gov.

Abstract

AIM:

Outcomes from out-of-hospital cardiac arrest (OHCA) may improve if rescuers perform chest compressions (CCs) deeper than the previous recommendation of 38-51mm and consistent with the 2010 AHA Guideline recommendation of at least 51mm. The aim of this study was to assess the relationship between CC depth and OHCA survival.

METHODS:

Prospective analysis of CC depth and outcomes in consecutive adult OHCA of presumed cardiac etiology from two EMS agencies participating in comprehensive CPR quality improvement initiatives.

ANALYSIS:

Multivariable logistic regression to calculate adjusted odds ratios (aORs) for survival to hospital discharge and favorable functional outcome.

RESULTS:

Among 593 OHCAs, 136 patients (22.9%) achieved return of spontaneous circulation, 63 patients (10.6%) survived and 50 had favorable functional outcome (8.4%). Mean CC depth was 49.8±11.0mm and mean CC rate was 113.9±18.1CCmin(-1). Mean depth was significantly deeper in survivors (53.6mm, 95% CI: 50.5-56.7) than non-survivors (48.8mm, 95% CI: 47.6-50.0). Each 5mm increase in mean CC depth significantly increased the odds of survival and survival with favorable functional outcome: aORs were 1.29 (95% CI 1.00-1.65) and 1.30 (95% CI 1.00-1.70) respectively.

CONCLUSION:

Deeper chest compressions were associated with improved survival and functional outcome following OHCA. Our results suggest that adhering to the 2010 AHA Guideline-recommended depth of at least 51mm could improve outcomes for victims of OHCA.

Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

KEYWORDS:

Cardiac arrest; Cardiopulmonary resuscitation; Compression depth

Comment in

PMID:
24125742
[PubMed - indexed for MEDLINE]
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