Chest compression-only cardiopulmonary resuscitation for out-of-hospital cardiac arrest with public-access defibrillation: a nationwide cohort study.
نویسندگان
چکیده
BACKGROUND It remains unclear which is more effective to increase survival after out-of-hospital cardiac arrest in those with public-access defibrillation, bystander-initiated chest compression-only cardiopulmonary resuscitation (CPR) or conventional CPR with rescue breathing. METHODS AND RESULTS A nationwide, prospective, population-based observational study covering the whole population of Japan and involving consecutive out-of-hospital cardiac arrest patients with resuscitation attempts has been conducted since 2005. We enrolled all out-of-hospital cardiac arrests of presumed cardiac origin that were witnessed and received shocks with public-access automated external defibrillation (AEDs) by bystanders from January 1, 2005, to December 31, 2009. The main outcome measure was neurologically favorable 1-month survival. We compared outcomes by type of bystander-initiated CPR (chest compression-only CPR and conventional CPR with compressions and rescue breathing). Multivariable logistic regression was used to assess the relationship between the type of CPR and a better neurological outcome. During the 5 years, 1376 bystander-witnessed out-of-hospital cardiac arrests of cardiac origin in individuals who received CPR and shocks with public-access AEDs by bystanders were registered. Among them, 506 (36.8%) received chest compression-only CPR and 870 (63.2%) received conventional CPR. The chest compression-only CPR group (40.7%, 206 of 506) had a significantly higher rate of 1-month survival with favorable neurological outcome than the conventional CPR group (32.9%, 286 of 870; adjusted odds ratio, 1.33; 95% confidence interval, 1.03-1.70). CONCLUSIONS Compression-only CPR is more effective than conventional CPR for patients in whom out-of-hospital cardiac arrest is witnessed and shocked with public-access defibrillation. Compression-only CPR is the most likely scenario in which lay rescuers can witness a sudden collapse and use public-access AEDs.
منابع مشابه
Effectiveness of Public Access Defibrillation with AEDs for Out-of-Hospital Cardiac Arrests in Japan.
In Japan, about 60,000 out-of-hospital cardiac arrests of cardiac etiology occur annually. Early initiation of cardiopulmonary resuscitation (CPR) and early defibrillation with public access automated external defibrillators (AEDs) by bystanders is the key to increasing survival after an out-of-hospital cardiac arrest (OHCA). Japanese data shows that nationwide dissemination of public access AE...
متن کاملContinuous-chest-compression cardiopulmonary resuscitation for cardiac arrest.
It is well known that out-of-hospital sudden cardiac death is a leading public health problem in the industrialized world. In the absence of early defibrillation, survival rates of patients with out-of-hospital cardiac arrest (OHCA) in most areas of the world are dismal and, except for a recent report of an improved rate of survival when their paramedic protocol was changed, have remained essen...
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1. International Liaison Committee on Resuscitation: 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation 2005; 112:III-1–III-136 2. Hazinski MF, Nadkarni VM, Hickey RW, et al: Major changes in the 2005 AHA guidelines for CPR and ECC: Reaching the tipping point for change Circulation 2005; 112(Suppl I...
متن کاملPublic access defibrillation in out-of-hospital cardiac arrest: a community-based study.
BACKGROUND The dissemination and use of automated external defibrillators (AEDs) beyond traditional emergency medical services (EMS) into the community has not been fully evaluated. We evaluated the frequency and outcome of non-EMS AED use in a community experience. METHODS AND RESULTS The investigation was a cohort study of out-of-hospital cardiac arrest cases due to underlying heart disease...
متن کاملChest compressions before defibrillation for out-of-hospital cardiac arrest: A meta-analysis of randomized controlled clinical trials
BACKGROUND Current 2005 guidelines for advanced cardiac life support strongly recommend immediate defibrillation for out-of-hospital cardiac arrest. However, findings from experimental and clinical studies have indicated a potential advantage of pretreatment with chest compression-only cardiopulmonary resuscitation (CPR) prior to defibrillation in improving outcomes. The aim of this meta-analys...
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ورودعنوان ژورنال:
- Circulation
دوره 126 24 شماره
صفحات -
تاریخ انتشار 2012