Abstract 57: Bystander Chest Compression-Alone Cardiopulmonary Resuscitation (CPR) For Patients With Out-Of-Hospital Cardiac Arrest Due To Non-Cardiac Causes
BACKGROUND Few clinical studies have focused on the efficacy of the technique of bystander CPR for patients with asphyxial arrest. In the 2005 AHA, we presented that bystander chest compression-alone CPR produced better neurological outcome compared with chest compression plus mouth-to-mouth ventilation CPR, but there was an insufficient data for patients with non-cardiac causes.
METHODS SOS-KANTO study conducted in 58 emergency hospitals and emergency medical service units. Paramedics evaluated the technique of bystander CPR on their arrival. The primary endpoint was a favorable neurological outcome at 30 days after cardiac arrest.
RESULTS Of 9,592 patients with out-of-hospital cardiac arrest, 1,456 adult victims who had bystander-witnessed cardiac arrest due to non-cardiac causes were enrolled; median call-to-patient’s side interval was 8 mins (interquaritile range; 6–10 mins), 137 received bystander chest compression-alone CPR, 216 received chest compression plus ventilation and 1,103 did not. No significant difference was observed in the primary outcome among the three groups (0.7 % with chest compression-alone CPR group, 1.9 % with chest compression plus ventilation CPR group, and 0.8 % with no bystander CPR group; P=0.35). Among subgroups of patients associated with respiratory accident (i.e., foreign body airway obstruction, submersion, et al), trauma, cerebrovascular accident or aortic accident, and patients receiving CPR from off-duty medical person or citizen, the two bystander CPR groups had similar frequencies of primary outcome. The multivariate odds ratio for primary outcome after chest compression-alone CPR was 1.0 (95 percent confidence interval, 0.1 to 8.0) and after chest compression plus ventilation, 2.1 (95 percent confidence interval, 0.6 to 7.0) among all 1,456 patients, although the independent factor was call-to-patient’s-side interval with an adjusted odds ratio of 0.7.
CONCLUSIONS Bystander chest compression-alone CPR was as effective as chest compression plus ventilation CPR, but chest compressions with or without ventilation did not produce better neurological outcome compared with no bystander CPR for patients with bystander-witnessed out-of-hospital cardiac arrest due to non-cardiac causes .