Abstract P73: Basic Resuscitation with Chest Compression Only is Effective against Postresuscitation Syndrome
BACKGROUND SOS-KANTO study showed that basic resuscitation with chest compressions only was the preferable approach to resuscitation for adult patients with witnessed out-of-hospital cardiac arrest (Lancet 2007; 369). However, few clinical studies have focused on the efficacy of bystander chest compression-only resuscitation for patients who had ROSC after out-of-hospital cardiac arrest.
METHODS SOS-KANTO study was conducted in 58 emergency hospitals and emergency medical service units. On arrival at the scene, paramedics assessed the technique of bystander resuscitation. The primary endpoint was a favorable neurological outcome 30 days after cardiac arrest.
RESULTS Of the 9,592 patients with out-of-hospital cardiac arrest, 2,689 adult patients who had ROSC were included; 287 received chest compression-only resuscitation, 424 received chest compressions plus mouth-to-mouth ventilations resuscitation, and 1,978 received no resuscitation. Not only the any resuscitation group, but also the chest compression-only resuscitation group had higher proportions of the favorable neurological outcome than the no resuscitation group in the whole cohort (9.9% vs. 5.1%; p<0.0001, and 11.2% vs. 5.1%; p<0.0001, respectively). The chest compression-only resuscitation group had higher proportion of the favorable neurological outcome than the chest compressions plus mouth-to-mouth ventilations resuscitation group in the subgroups of patients with use of epinephrine (4.4% vs. 1.1%, p=0.008), but there was no evidence for any benefit from the addition of mouth-to-mouth ventilation in any subgroups. Furthermore the adjusted odds ratios for the favorable neurological outcome after chest compression-only resuscitation and was 1.7 (95% CI, 1.1 to 2.8, p=0.030), and after chest compressions plus mouth-to-mouth ventilations resuscitation, 1.3 (95% CI, 0.8 to 2.0, p=0.252).
CONCLUSIONS In terms of neurological benefit, chest compression-only resuscitation is superior to chest compressions plus mouth-to-mouth ventilations even though the adult patients with ROSC after cardiac arrest. We conclude that basic resuscitation with chest compressions only is effective against postresuscitation syndrome.