The Impact of Increased Chest Compression Fraction on Return of Spontaneous Circulation for Out-of-Hospital Cardiac Arrest Patients not in Ventricular Fibrillation

Resuscitation, 07/18/2011

Vaillancourt C et al.– This is the first study to demonstrate that increased chest compression fraction (CCF) among non–ventricular fibrillation (VF) out–of–hospital cardiac arrest (OOHCA) patients is associated with a trend toward increased likelihood of return of spontaneous circulation (ROSC).

Methods

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

Results

  • Demographics of 2,103 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 8min:27sec; 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).

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