Tasuku Matsuyama1, Tetsuhisa Kitamura2, Kosuke Kiyohara3, Chika Nishiyama4, Tatsuya Nishiuchi5, Yasuyuki Hayashi6, Takashi Kawamura7, Bon Ohta1, Taku Iwami7. 1. Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan. 2. Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan. Electronic address: lucky_unatan@yahoo.co.jp. 3. Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan. 4. Department of Critical Care Nursing, Kyoto University Graduate School of Human Health Science, Kyoto, Japan. 5. Department of Acute Medicine, Kindai University Faculty of Medicine, Osaka, Japan. 6. Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, Osaka, Japan. 7. Kyoto University Health Services, Kyoto, Japan.
Abstract
BACKGROUND: The optimal cardiopulmonary resuscitation (CPR) duration for patients with out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to assess the association between CPR duration and outcome after OHCA. METHODS: This prospective, population-based observational study conducted in Osaka, Japan enrolled 6981 adult patients with non-traumatic witnessed OHCA who achieved return of spontaneous circulation (ROSC) from January 2005 through December 2012. CPR duration was defined as the time of CPR initiation by emergency medical service personnel to the ROSC in pre-hospital settings or after hospital admission. The primary outcome was one-month survival with neurologically favourable outcome (cerebral performance category scale 1 or 2). RESULTS: Overall, median CPR duration was 25min (interquartile range: 15-34) and the proportion of neurologically favourable outcome was 12.5% (875/6,981). The proportion of neurologically favourable outcome among the CPR duration ≥31min group was significantly lower compared with that among the 0-5min group (55.1% [320/581] versus 2.2% [54/2424], adjusted odds ratio [AOR] 0.04; 95% confidence interval [CI] 0.03-0.05 in all patients, 78.4% [240/306] versus 11.4% [30/264], AOR 0.04; 95% CI 0.02-0.06 in the shockable group, 29.1% [80/275] versus 1.1% [24/2160], and AOR 0.03; 95% CI 0.02-0.05 in the non-shockable group). The cumulative proportion for neurologically favourable outcome reached 99% after 44, 41, and 43min of CPR in all patients, the shockable group, and the non-shockable group, respectively. CONCLUSION: The proportion of patients with neurologically favourable outcome declined with increasing CPR duration, but some OHCA patients could benefit from prolonged CPR duration >30min.
BACKGROUND: The optimal cardiopulmonary resuscitation (CPR) duration for patients with out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to assess the association between CPR duration and outcome after OHCA. METHODS: This prospective, population-based observational study conducted in Osaka, Japan enrolled 6981 adult patients with non-traumatic witnessed OHCA who achieved return of spontaneous circulation (ROSC) from January 2005 through December 2012. CPR duration was defined as the time of CPR initiation by emergency medical service personnel to the ROSC in pre-hospital settings or after hospital admission. The primary outcome was one-month survival with neurologically favourable outcome (cerebral performance category scale 1 or 2). RESULTS: Overall, median CPR duration was 25min (interquartile range: 15-34) and the proportion of neurologically favourable outcome was 12.5% (875/6,981). The proportion of neurologically favourable outcome among the CPR duration ≥31min group was significantly lower compared with that among the 0-5min group (55.1% [320/581] versus 2.2% [54/2424], adjusted odds ratio [AOR] 0.04; 95% confidence interval [CI] 0.03-0.05 in all patients, 78.4% [240/306] versus 11.4% [30/264], AOR 0.04; 95% CI 0.02-0.06 in the shockable group, 29.1% [80/275] versus 1.1% [24/2160], and AOR 0.03; 95% CI 0.02-0.05 in the non-shockable group). The cumulative proportion for neurologically favourable outcome reached 99% after 44, 41, and 43min of CPR in all patients, the shockable group, and the non-shockable group, respectively. CONCLUSION: The proportion of patients with neurologically favourable outcome declined with increasing CPR duration, but some OHCA patients could benefit from prolonged CPR duration >30min.
Authors: Gavin D Perkins; Claire Kenna; Chen Ji; Charles D Deakin; Jerry P Nolan; Tom Quinn; Charlotte Scomparin; Rachael Fothergill; Imogen Gunson; Helen Pocock; Nigel Rees; Lyndsey O'Shea; Judith Finn; Simon Gates; Ranjit Lall Journal: Intensive Care Med Date: 2020-01-07 Impact factor: 17.440
Authors: SungJoon Park; Sung Woo Lee; Kap Su Han; Eui Jung Lee; Dong-Hyun Jang; Si Jin Lee; Ji Sung Lee; Su Jin Kim Journal: Scand J Trauma Resusc Emerg Med Date: 2022-01-15 Impact factor: 2.953
Authors: Helen Pocock; Charles D Deakin; Ranjit Lall; Felix Michelet; Abraham Contreras; Mark Ainsworth-Smith; Phil King; Anne Devrell; Debra E Smith; Gavin D Perkins Journal: Resusc Plus Date: 2022-10-06
Authors: Spyros D Mentzelopoulos; Keith Couper; Patrick Van de Voorde; Patrick Druwé; Marieke Blom; Gavin D Perkins; Ileana Lulic; Jana Djakow; Violetta Raffay; Gisela Lilja; Leo Bossaert Journal: Notf Rett Med Date: 2021-06-02 Impact factor: 0.826