The Impact of Increased Chest Compression Fraction on Return of Spontaneous Circulation for Out-of-Hospital Cardiac Arrest Patients not in Ventricular Fibrillation
| Autor: | Douglas L. Andrusiek, Judy Powell, Siobhan Everson-Stewart, Sheldon Cheskes, Tom P. Aufderheide, Robert A. Berg, Christian Vaillancourt, Jim Christenson, Ian G. Stiell, Graham Nichol |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Resuscitation Canada Emergency Medical Services Time Factors medicine.medical_treatment Emergency Nursing Return of spontaneous circulation Article Internal medicine medicine Odds Ratio Humans Cardiopulmonary resuscitation Prospective Studies Asystole Survival rate Automated external defibrillator Aged business.industry Recovery of Function Thorax medicine.disease Confidence interval United States Cardiopulmonary Resuscitation Survival Rate Ventricular fibrillation Blood Circulation Ventricular Fibrillation Emergency Medicine Cardiology Female Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest Follow-Up Studies |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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