Bystander chest compression-only cardiopulmonary resuscitation increased survival of non-asphyxial out-of hospital cardiac arrest patients

SOURCE

Zhan L, Yang LJ, Huang Y, et al (2017) Continuous chest compression versus interrupted chest compression for cardiopulmonary resuscitation of non-asphyxial out-of-hospital cardiac arrest. Cochrane Database Syst Rev 27;3:CD010134.

CONTEXT

Non-asphyxial out-of-hospital cardiac arrest (OHCA) is a significant cause of death worldwide. Cardiopulmonary resuscitation (CPR) is a well-established treatment for cardiac arrest and must be rapidly initiated by rescuers (bystanders or professional CPR providers).

CLINICAL QUESTION

For non-asphyxial OHCA, should the rescuersperform continuous chest compression CPR (with or without rescue breaths, CCC-CPR) or conventional CPR plus rescue breathing (interrupted chest compression withpauses for breaths)?

BOTTOM LINE

Bystander-administered

Chest compression-only CPR (without rescue breaths), supported by telephone instruction, increased the proportion of people who survive to hospital discharge compared with conventional interrupted chest compression CPR with rescue breaths (high quality of evidence).

Trained professionals

There is no significant difference regarding the return of spontaneous circulation, survival to hospital admission, survival to hospital dischargeand adverse events between CCC-CPR with asynchronous rescue breaths compared to interrupted chest compressions with rescue breaths (moderate quality of evidence).

CAVEAT

Only four articles were selected and contributed to the results: one for trained professionals, and three for bystanders. In one of these articles, children older than one year of age were also included. It did not allow to conclude which CPR to be used.Finally, there is no data available regarding survival at one year or quality of life, and evidence regarding the neurological outcomes of survival was insufficient.

AUTHOR INFORMATION

Daniel MEYRAN
Bataillon de Marins Pompiers de Marseille
Marseille, France
daniel.meyran@me.com

Haldun AKOGLU
Marmara University Faculty of Medicine
Istanbul, Turkey
drhaldun@gmail.com