The impact of increased chest compression fraction on survival for out-of-hospital cardiac arrest patients with a non-shockable initial rhythm
| Autor: | James J. Menegazzi, Sheldon Cheskes, Jason E. Buick, Robert A. Berg, Ian G. Stiell, Raymond L. Fowler, Ritu Sahni, Graham Nichol, Tom P. Aufderheide, Eric N. Meier, Douglas L. Andrusiek, Christian Vaillancourt, T.J. Bishop, M. Riccardo Colella, Ahamed H. Idris, Jim Christenson, Debra Egan, Daniel Davis, Ashley Petersen, Clifton W. Callaway |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Canada Emergency Medical Services Resuscitation Patients medicine.medical_treatment Heart Massage 030204 cardiovascular system & hematology Emergency Nursing Return of spontaneous circulation Article 03 medical and health sciences 0302 clinical medicine medicine Humans Prospective Studies Cardiopulmonary resuscitation Asystole Prospective cohort study Automated external defibrillator Aged Retrospective Studies business.industry 030208 emergency & critical care medicine Odds ratio Thorax medicine.disease Cardiopulmonary Resuscitation Confidence interval Anesthesia Emergency Medicine Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest |
| Zdroj: | Resuscitation |
| ISSN: | 0300-9572 |
| Popis: | Objective We evaluated the effect of chest compression fraction (CCF) on survival to hospital discharge and return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) patients with non-shockable rhythms. Methods This is a retrospective analysis (completed in 2016) of a prospective cohort study which included OHCA patients from ten U.S. and Canadian sites (Resuscitation Outcomes Consortium Epistry and PRIMED study (2007–2011)). We included all OHCA victims of presumed cardiac aetiology, not witnessed by emergency medical services (EMS), without automated external defibrillator shock prior to EMS arrival, receiving > 1 min of CPR with CPR process measures available, and initial non-shockable rhythm. We measured CCF using the first 5 min of electronic CPR records. Results Demographics of 12,928 adult patients were: mean age 68; male 59.9%; public location 8.5%; bystander witnessed 35.2%; bystander CPR 39.3%; median interval from 911 to defibrillator turned on 10 min:04 s; initial rhythm asystole 64.8%, PEA 26.0%, other non-shockable 9.2%; compression rate 80−120/min (69.1%); median CCF 74%; ROSC 25.6%; survival to hospital discharge 2.4%. Adjusted odds ratio (OR); 95% confidence intervals (95%CI) of survival for each CCF category were: 0−40% (2.00; 1.16, 3.32); 41−60% (0.83; 0.54, 1.24); 61−80% (1.02; 0.77, 1.35); and 81−100% (reference group). Adjusted (OR; 95%CI) of ROSC for each CCF category were: 0−40% (1.02; 0.79, 1.30); 41−60% (0.83; 0.72, 0.95); 61−80% (0.85; 0.77, 0.94); and 81−100% (reference group). Conclusions We observed an incremental benefit from higher CCF on the incidence of ROSC, but not survival, among non-shockable OHCA patients with CCF higher than 40%. |
| Databáze: | OpenAIRE |
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