Influence of compression rate on initial success of resuscitation and 24 hour survival after prolonged manual cardiopulmonary resuscitation in dogs.

Feneley, Michael P.; Maier, G. W.; Kern, Karl B.; Gaynor, J. William; Gall, Stanley A.; Sanders, Arthur B.; Raessler, Kenneth L.; Muhlbaier, Lawrence H.; Rankin, J S; Ewy, G A

doi:10.1161/01.cir.77.1.240

Cited by 153 publications

(77 citation statements)

References 40 publications

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“…18,19 Prior laboratory investigations have shown that slow rates of compression do not generate sufficient flow to sustain resuscitation 20 and that higher chest compression rates are associated with improved measures of perfusion. 21 In this preliminary study, we have not considered depth of compressions or rate and depth of ventilation.…”

Section: Discussionmentioning

confidence: 99%

Chest Compression Rates During Cardiopulmonary Resuscitation Are Suboptimal

et al. 2005

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Background-Recent data highlight a vital link between well-performed cardiopulmonary resuscitation (CPR) and survival after cardiac arrest; however, the quality of CPR as actually performed by trained healthcare providers is largely unknown. We sought to measure in-hospital chest compression rates and to determine compliance with published international guidelines. Methods and Results-We developed and validated a handheld recording device to measure chest compression rate as a surrogate for CPR quality. A prospective observational study of adult cardiac arrests was performed at 3 hospitals from April 2002 to October 2003. Resuscitations were witnessed by trained observers using a customized personal digital assistant programmed to store the exact time of each chest compression, allowing offline calculation of compression rates at serial time points. In 97 arrests, data from 813 minutes during which chest compressions were delivered were analyzed in 30-second time segments. In 36.9% of the total number of segments, compression rates were Ͻ80 compressions per minute (cpm), and 21.7% had rates Ͻ70 cpm. Higher chest compression rates were significantly correlated with initial return of spontaneous circulation (mean chest compression rates for initial survivors and nonsurvivors, 90Ϯ17 and 79Ϯ18 cpm, respectively; Pϭ0.0033). Conclusions-In-hospital chest compression rates were below published resuscitation recommendations, and suboptimal compression rates in our study correlated with poor return of spontaneous circulation. CPR quality is likely a critical determinant of survival after cardiac arrest, suggesting the need for routine measurement, monitoring, and feedback systems during actual resuscitation. (Circulation. 2005;111:428-434.)

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Section: Discussionmentioning

confidence: 99%

Chest Compression Rates During Cardiopulmonary Resuscitation Are Suboptimal

et al. 2005

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“…[3][4][5] Faster chest compression rates (120 vs. 60 min -1 ) improved immediate and 24 hour survival after ventricular fibrillation arrest in an animal study. 6 Human studies have also shown improved survival from faster compression rates. Abella and colleagues found a higher mean compression rate for in-hospital cardiac arrest patients with initial return of spontaneous circulation (ROSC) compared with no-ROSC (90±17 vs.…”

Section: Introductionmentioning

confidence: 99%

The impact of chest compression rates on quality of chest compressions – A manikin study

et al. 2012

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“…This concept was foreign to our resuscitation research group, as well as to resuscitation researchers in the Department of Surgery and Physiology at Duke University Medical Center (Durham, NC, USA), leading us to cooperate in a study to compare the survival of animals with VF arrest treated with manual chest compression rates of 60/min versus 120/min 5. “We found that when compared with the compression rate of 60/min, a compression rate of 120/min produced more successfully defibrillated animals; 12/13 of animals receiving compressions at 120/min versus 2/13 at a chest compression rate of 60/min P < 0.002” 5. “And more 24 h survivors (8/13) at the fast chest compression rate versus 2/13 at 60/min P < 0.03.…”

Section: Discussionmentioning

confidence: 99%

The mechanism of blood flow during chest compressions for cardiac arrest is probably influenced by the patient's chest configuration

Ewy

2018

Acute Medicine & Surgery

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AimMechanical assist devices are sometimes needed during resuscitation efforts of patients with prolonged cardiac arrest. Two such devices, the AutoPulse and the LUCAS, have different mechanisms of action. We propose that the effectiveness of mechanical assist devices is somewhat dependent on the configuration and compliance of the patient's chest wall.MethodsA previous study of patients with out‐of‐hospital cardiac arrest in Arizona reported that survivors were younger and many were observed to have narrow anterior–posterior chest diameters. These observations suggest that the predominant mechanism of blood flow during cardiopulmonary resuscitation of individuals with primary cardiac arrest is influenced by the patient's anterior–posterior chest diameter and compliance. It is proposed that in older individuals with an increased anterior–posterior chest diameter and decreased chest compliance that the AutoPulse, which works by increasing intrathoracic pressures, may be more effective. In contrast, the LUCAS device, which works predominately by compression of the sternum, is probably more effective in patients with narrower anterior–posterior diameters and a more compliant chest.ResultsThese hypotheses need to be confirmed by researchers who not only have access to the lateral chest roentgenograms of patients with cardiac arrest, to determine their anterior–posterior chest diameter, but also to the type of mechanical device that was used during resuscitation efforts and their patient's survival. If the observations herein proposed are confirmed, hospitals and paramedics may ideally need to have one of each type of mechanical chest compression unit and select the one to use depending on the patient's age and anterior–posterior chest diameter.ConclusionsThe mechanism of blood flow in patients with cardiac arrest is predominantly secondary to cardiac compression in younger patients with narrow anterior chest diameters and predominately secondary to the thoracic pump mechanism in older patients with emphysema.

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Influence of compression rate on initial success of resuscitation and 24 hour survival after prolonged manual cardiopulmonary resuscitation in dogs.

Cited by 153 publications

References 40 publications

Chest Compression Rates During Cardiopulmonary Resuscitation Are Suboptimal

Chest Compression Rates During Cardiopulmonary Resuscitation Are Suboptimal

The impact of chest compression rates on quality of chest compressions – A manikin study

The mechanism of blood flow during chest compressions for cardiac arrest is probably influenced by the patient's chest configuration

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