Bystander CPR up to 10 minutes after cardiac arrest still can save a life
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Key takeaways:
- Bystander CPR up to 10 minutes after a cardiac arrest can improve survival odds and brain function.
- Odds of survival became less effective with delayed start time of CPR.
CHICAGO — Adults who received bystander CPR within the first few minutes of an out-of-hospital cardiac arrest were much more likely to survive and have better brain function than those who did not, researchers reported.
Bystander CPR is a critical link in the chain of survival for out-of-hospital cardiac arrest; however, there may be a time threshold beyond which bystander CPR is no longer associated with improved odds of survival, Evan O’Keefe, MD, a cardiology fellow at Saint Luke’s Mid America Heart Institute and University of Missouri-Kansas City, said during a presentation at the American Heart Association Scientific Sessions.
“The longer it took for CPR to start, the less effective it became,” O’Keefe told Healio. “However, even up to 10 minutes after cardiac arrest, there was a significant survival benefit from bystander CPR.”
Researchers analyzed data from 198,869 witnessed out-of-hospital cardiac arrests that occurred from 2013 through 2022. The mean age of people experiencing an arrest was 64 years and 34% were women. Time to initiation of bystander CPR was categorized in 2-minute intervals (0-1, 2-3, 4-5, 6-7, 8-9, 10-plus minutes). Researchers evaluated the association between each time interval for initiation of bystander CPR and survival to discharge and favorable neurological survival.
Among people who did not receive bystander CPR, 11.9% survived to discharge and 9.3% had favorable neurological survival.
Those who received bystander CPR within 2 minutes of cardiac arrest had relatively higher rates of survival to discharge (OR = 1.85; 95% CI, 1.79-1.92; P < .001) and favorable neurological survival (OR = 1.99; 95% CI, 1.92-2.07; P < .001).
Compared with no bystander CPR, survival benefit of bystander CPR decreased with each subsequent time interval and was no longer associated with improved survival when bystander CPR was initiated 10 or more minutes after the onset of an out-of-hospital cardiac arrest.
“In regard to CPR, the sooner you start, the better,” O’Keefe told Healio. “Even a few minutes' delay can make a big difference. Having said that, even CPR started by a bystander up to 10 minutes after cardiac arrest gives that patient a markedly better chance of surviving.”
O’Keefe said more research is needed on the utility of apps that alert nearby trained bystanders and on revised protocols for dispatchers to recognize cardiac arrest and provide CPR instructions over the phone.
“We need to focus not only on teaching more people how to perform CPR, but also on ways to get help to cardiac arrest victims faster,” O’Keefe told Healio. “This might include better public access to defibrillators, improved dispatch systems or more widespread CPR training programs.”
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O’Keefe E, et al. Abstract Or104. Presented at: American Heart Association Scientific Sessions; Nov. 16-18, 2024; Chicago.
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