This article is more than 5 years old. Information may no longer be current.
No difference in early vs. later CPR in cardiac arrest patients
Stiell IG. N Engl J Med. 2011;365:787-797.
Click Here to Manage Email Alerts
There was no outcome difference between a brief period vs. a longer period of CPR administered by emergency medical service before the first analysis of cardiac rhythm, according to a study.
The Resuscitation Outcomes Consortium was a cluster-randomized clinical trial that included 150 emergency medical service agencies and 9,933 patients who had an out-of-hospital cardiac arrest not resulting from trauma or who were treated with defibrillation, delivery of chest compressions or both, according to the study. Researchers divided participating centers into 20 clusters and randomly assigned patients into an early-analysis group and later-analysis group. The early-analysis group received 30 to 60 seconds of chest compressions and ventilations before electrocardiographic analysis, and the later-analysis group received 3 minutes of chest compressions and ventilations before ECG analysis. The early-analysis CPR strategy was set to a period of 3 to 12 months before being assigned to the later-analysis group. Primary outcome was based on survival to hospital discharge with satisfactory functional status as indicated by a modified Rankin scale score of 3 or less on a scale of 0 to 6.
The trial ran from June 2007 to November 2009 with 5,290 patients in the early-analysis group and 4,643 patients in the later-analysis group. When it came to the primary outcome, 5.9% (n=310) early-analysis patients and 5.9% (n=273) later-analysis patients met criteria with a cluster-adjusted difference of –0.2 percentage points (95% CI, –1.1 to 0.7). When analyzed on an as-treated basis, the outcome rates of survival with satisfactory functional status were 6% among 3,982 patients receiving early analysis and 5.9% among 3,115 patients receiving later analysis (P=.97), according to the study. Researchers also found that patients’ chance of survival with satisfactory functional status did not improve with increasing time of the first analysis of cardiac rhythm. Patients’ rate of survival declined with increasing time to the first rhythm analysis if patients with an initial rhythm of ventricular tachycardia or ventricular fibrillation received CPR from a bystander.
Disclosure: Dr. Stiell received grants from the National Heart, Lung, and Blood Institute, the National Institute of Neurological Disorders and Stroke, the Canadian Institutes of Health Research-Institute of Circulatory and Respiratory Health, and the Heart and Stroke Foundation of Canada.
 |
Follow CardiologyToday.com on Twitter. |