Improved survival outcome with continuous chest compressions with ventilation compared to 5

1 compressions-to-ventilations mechanical cardiopulmonary resuscitation in out-of-hospital cardiac arrest

I. Hsin Lee, Chorng Kuang How, Wen Hua Lu, Yuann Meei Tzeng, Ying Ju Chen, Chii Hwa Chern, Wei Fong Kao, David Hung Tsang Yen, Mu Shun Huang

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Fewer pauses and better chest compression quality are thought to improve overall survival following cardiac arrest. This study aimed to measure the outcomes of adult nontraumatic out-of-hospital cardiac arrests (OHCAs) treated with 5:1 compressions-to-ventilations (Thumper 1007) or continuous chest compressions with ventilation (Thumper 1008 CCV) mechanical cardiopulmonary resuscitation (CPR) within a specified period of time. Methods: A retrospective observational cohort study of 515 adults with OHCA was conducted at the emergency department of an urban tertiary hospital. There were 307 patients in the Thumper 1007 phase (January 2008 to December 2009) and 208 patients in the Thumper 1008 CCV phase (January 2010 to May 2011). Return of spontaneous circulation (ROSC) and survival to hospital discharge were the primary outcome measures. Results: Patients in the Thumper 1007 and Thumper 1008 CCV phases had comparable results with the following exceptions: less hypertension (42.4% vs. 62.0%), cerebrovascular accidents (11.4% vs. 25.0%), and faster emergency medical service response time intervals (mean, 3.7 vs. 4.5 minutes) with the Thumper 1007. The average ambulance transport time was 6.1 minutes in both phases. The rates of ROSC [35.1% vs. 23.5%; adjusted odds ratio (OR), 1.616; 95% confidence interval (CI), 1.073-2.432] and survival to hospital discharge (10.1% vs. 4.2%; adjusted OR 2.431; 95% CI, 1.154-5.120) were significantly higher with the Thumper 1008 CCV than with the Thumper 1007. Favorable neurologic outcome upon discharge, defined as cerebral performance category scores of 1 (good performance) or 2 (moderate disability), was not significantly different between the two phases [1.6% (5/307) vs. 1.9% (4/208); p = 0.802]. The Thumper 1008 CCV provided significantly faster average chest compression rates and shorter no-chest compression intervals than the Thumper 1007 after activation. Conclusion: In an emergency department with short ambulance transport times, continuous chest compressions with ventilation through mechanical CPR showed improved outcomes, including ROSC and survival to hospital discharge, in an adult with OHCA. However, there are a variety of confounding influences that may affect the validity of conclusions that have been drawn.

Original languageEnglish
Pages (from-to)158-163
Number of pages6
JournalJournal of the Chinese Medical Association
Volume76
Issue number3
DOIs
Publication statusPublished - Mar 2013
Externally publishedYes

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Out-of-Hospital Cardiac Arrest
Cardiopulmonary Resuscitation
Artificial Respiration
Ventilation
Thorax
Survival
Ambulances
Hospital Emergency Service
Odds Ratio
Outcome Assessment (Health Care)
Confidence Intervals
Urban Hospitals
Emergency Medical Services
Heart Arrest
Tertiary Care Centers
Nervous System
Reaction Time
Observational Studies
Cohort Studies
Stroke

Keywords

  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Resuscitation
  • Return of spontaneous circulation
  • Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Improved survival outcome with continuous chest compressions with ventilation compared to 5 : 1 compressions-to-ventilations mechanical cardiopulmonary resuscitation in out-of-hospital cardiac arrest. / Lee, I. Hsin; How, Chorng Kuang; Lu, Wen Hua; Tzeng, Yuann Meei; Chen, Ying Ju; Chern, Chii Hwa; Kao, Wei Fong; Yen, David Hung Tsang; Huang, Mu Shun.

In: Journal of the Chinese Medical Association, Vol. 76, No. 3, 03.2013, p. 158-163.

Research output: Contribution to journalArticle

Lee, I. Hsin ; How, Chorng Kuang ; Lu, Wen Hua ; Tzeng, Yuann Meei ; Chen, Ying Ju ; Chern, Chii Hwa ; Kao, Wei Fong ; Yen, David Hung Tsang ; Huang, Mu Shun. / Improved survival outcome with continuous chest compressions with ventilation compared to 5 : 1 compressions-to-ventilations mechanical cardiopulmonary resuscitation in out-of-hospital cardiac arrest. In: Journal of the Chinese Medical Association. 2013 ; Vol. 76, No. 3. pp. 158-163.
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abstract = "Background: Fewer pauses and better chest compression quality are thought to improve overall survival following cardiac arrest. This study aimed to measure the outcomes of adult nontraumatic out-of-hospital cardiac arrests (OHCAs) treated with 5:1 compressions-to-ventilations (Thumper 1007) or continuous chest compressions with ventilation (Thumper 1008 CCV) mechanical cardiopulmonary resuscitation (CPR) within a specified period of time. Methods: A retrospective observational cohort study of 515 adults with OHCA was conducted at the emergency department of an urban tertiary hospital. There were 307 patients in the Thumper 1007 phase (January 2008 to December 2009) and 208 patients in the Thumper 1008 CCV phase (January 2010 to May 2011). Return of spontaneous circulation (ROSC) and survival to hospital discharge were the primary outcome measures. Results: Patients in the Thumper 1007 and Thumper 1008 CCV phases had comparable results with the following exceptions: less hypertension (42.4{\%} vs. 62.0{\%}), cerebrovascular accidents (11.4{\%} vs. 25.0{\%}), and faster emergency medical service response time intervals (mean, 3.7 vs. 4.5 minutes) with the Thumper 1007. The average ambulance transport time was 6.1 minutes in both phases. The rates of ROSC [35.1{\%} vs. 23.5{\%}; adjusted odds ratio (OR), 1.616; 95{\%} confidence interval (CI), 1.073-2.432] and survival to hospital discharge (10.1{\%} vs. 4.2{\%}; adjusted OR 2.431; 95{\%} CI, 1.154-5.120) were significantly higher with the Thumper 1008 CCV than with the Thumper 1007. Favorable neurologic outcome upon discharge, defined as cerebral performance category scores of 1 (good performance) or 2 (moderate disability), was not significantly different between the two phases [1.6{\%} (5/307) vs. 1.9{\%} (4/208); p = 0.802]. The Thumper 1008 CCV provided significantly faster average chest compression rates and shorter no-chest compression intervals than the Thumper 1007 after activation. Conclusion: In an emergency department with short ambulance transport times, continuous chest compressions with ventilation through mechanical CPR showed improved outcomes, including ROSC and survival to hospital discharge, in an adult with OHCA. However, there are a variety of confounding influences that may affect the validity of conclusions that have been drawn.",
keywords = "Cardiac arrest, Cardiopulmonary resuscitation, Resuscitation, Return of spontaneous circulation, Survival",
author = "Lee, {I. Hsin} and How, {Chorng Kuang} and Lu, {Wen Hua} and Tzeng, {Yuann Meei} and Chen, {Ying Ju} and Chern, {Chii Hwa} and Kao, {Wei Fong} and Yen, {David Hung Tsang} and Huang, {Mu Shun}",
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T1 - Improved survival outcome with continuous chest compressions with ventilation compared to 5

T2 - 1 compressions-to-ventilations mechanical cardiopulmonary resuscitation in out-of-hospital cardiac arrest

AU - Lee, I. Hsin

AU - How, Chorng Kuang

AU - Lu, Wen Hua

AU - Tzeng, Yuann Meei

AU - Chen, Ying Ju

AU - Chern, Chii Hwa

AU - Kao, Wei Fong

AU - Yen, David Hung Tsang

AU - Huang, Mu Shun

PY - 2013/3

Y1 - 2013/3

N2 - Background: Fewer pauses and better chest compression quality are thought to improve overall survival following cardiac arrest. This study aimed to measure the outcomes of adult nontraumatic out-of-hospital cardiac arrests (OHCAs) treated with 5:1 compressions-to-ventilations (Thumper 1007) or continuous chest compressions with ventilation (Thumper 1008 CCV) mechanical cardiopulmonary resuscitation (CPR) within a specified period of time. Methods: A retrospective observational cohort study of 515 adults with OHCA was conducted at the emergency department of an urban tertiary hospital. There were 307 patients in the Thumper 1007 phase (January 2008 to December 2009) and 208 patients in the Thumper 1008 CCV phase (January 2010 to May 2011). Return of spontaneous circulation (ROSC) and survival to hospital discharge were the primary outcome measures. Results: Patients in the Thumper 1007 and Thumper 1008 CCV phases had comparable results with the following exceptions: less hypertension (42.4% vs. 62.0%), cerebrovascular accidents (11.4% vs. 25.0%), and faster emergency medical service response time intervals (mean, 3.7 vs. 4.5 minutes) with the Thumper 1007. The average ambulance transport time was 6.1 minutes in both phases. The rates of ROSC [35.1% vs. 23.5%; adjusted odds ratio (OR), 1.616; 95% confidence interval (CI), 1.073-2.432] and survival to hospital discharge (10.1% vs. 4.2%; adjusted OR 2.431; 95% CI, 1.154-5.120) were significantly higher with the Thumper 1008 CCV than with the Thumper 1007. Favorable neurologic outcome upon discharge, defined as cerebral performance category scores of 1 (good performance) or 2 (moderate disability), was not significantly different between the two phases [1.6% (5/307) vs. 1.9% (4/208); p = 0.802]. The Thumper 1008 CCV provided significantly faster average chest compression rates and shorter no-chest compression intervals than the Thumper 1007 after activation. Conclusion: In an emergency department with short ambulance transport times, continuous chest compressions with ventilation through mechanical CPR showed improved outcomes, including ROSC and survival to hospital discharge, in an adult with OHCA. However, there are a variety of confounding influences that may affect the validity of conclusions that have been drawn.

AB - Background: Fewer pauses and better chest compression quality are thought to improve overall survival following cardiac arrest. This study aimed to measure the outcomes of adult nontraumatic out-of-hospital cardiac arrests (OHCAs) treated with 5:1 compressions-to-ventilations (Thumper 1007) or continuous chest compressions with ventilation (Thumper 1008 CCV) mechanical cardiopulmonary resuscitation (CPR) within a specified period of time. Methods: A retrospective observational cohort study of 515 adults with OHCA was conducted at the emergency department of an urban tertiary hospital. There were 307 patients in the Thumper 1007 phase (January 2008 to December 2009) and 208 patients in the Thumper 1008 CCV phase (January 2010 to May 2011). Return of spontaneous circulation (ROSC) and survival to hospital discharge were the primary outcome measures. Results: Patients in the Thumper 1007 and Thumper 1008 CCV phases had comparable results with the following exceptions: less hypertension (42.4% vs. 62.0%), cerebrovascular accidents (11.4% vs. 25.0%), and faster emergency medical service response time intervals (mean, 3.7 vs. 4.5 minutes) with the Thumper 1007. The average ambulance transport time was 6.1 minutes in both phases. The rates of ROSC [35.1% vs. 23.5%; adjusted odds ratio (OR), 1.616; 95% confidence interval (CI), 1.073-2.432] and survival to hospital discharge (10.1% vs. 4.2%; adjusted OR 2.431; 95% CI, 1.154-5.120) were significantly higher with the Thumper 1008 CCV than with the Thumper 1007. Favorable neurologic outcome upon discharge, defined as cerebral performance category scores of 1 (good performance) or 2 (moderate disability), was not significantly different between the two phases [1.6% (5/307) vs. 1.9% (4/208); p = 0.802]. The Thumper 1008 CCV provided significantly faster average chest compression rates and shorter no-chest compression intervals than the Thumper 1007 after activation. Conclusion: In an emergency department with short ambulance transport times, continuous chest compressions with ventilation through mechanical CPR showed improved outcomes, including ROSC and survival to hospital discharge, in an adult with OHCA. However, there are a variety of confounding influences that may affect the validity of conclusions that have been drawn.

KW - Cardiac arrest

KW - Cardiopulmonary resuscitation

KW - Resuscitation

KW - Return of spontaneous circulation

KW - Survival

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