Abstract 11341: Comparison of a 30: 2 Compression-Ventilation Ratio with a 15: 2 Compression-Ventilation Ratio for Patients Who Received Bystander Cardiopulmonary Resuscitation After Out-of-Hospital Cardiac Arrest
Background: The AHA 2005 guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) have recommended that lay rescuers use a 30:2 compression-ventilation ratio for all victims with out-of-hospital cardiac arrest. It is not known whether the neurologically intact survival rate will increase if lay rescuers perform CPR with a 30:2 compression-ventilation ratio.
Methods: The JCS-ReSS investigated the effect of the change to a 30:2 compression-ventilation ratio for CPR, compared with a 15:2 compression-ventilation ratio. Data of patients with out-of-hospital cardiac arrest from the all-Japan Utstein Registry of the Fire and Disaster Management Agency were analyzed. The primary end point was a 30-day neurologically intact survival.
Results: Of the 19,480 patients with witnessed out-of-hospital cardiac arrest due to cardiac etiology, with an age of 8 years and over, and with shockable cardiac arrest rhythm on EMS arrival at the patients side, 3,764 patients who received CPR with chest compression plus mouth-to-mouth ventilation by citizens (family or unrelated persons) were included; 1,992 received a 15:2 compression-ventilation ratio in the 2000 CPR guidelines era (the 15:2 group), 1,772 received a 30:2 compression-ventilation ratio in the 2005 CPR guidelines era (the 30:2 group). The 30:2 group had higher proportions of 30-day neurologically intact survival than the 15:2 group among all patients in the study (23.6% vs. 16.7%; p<0.0001), and in the subgroups of patients with bystander CPR by family (19.4% vs. 13.4%; p=0.001), with bystander CPR by unrelated persons (27.2% vs. 19.5%; p<0.0001), and with call-to-EMS arrival at the patient side interval in three of four quartiles (quartile 1; 34.9% vs. 26.9%; p=0.03, quartile 2; 29.9% vs. 19.9%, p<0.0001, quartile 3; 21.0% vs. 13.3%, p=0.002). A multiple logistic-regression analysis showed that the adjusted odds ratio for a 30-day neurologically intact survival after a 30:2 compression-ventilation ratio for CPR was 1.57 (95% CI, 1. 33 to 1.85, p<0.0001).
Conclusions: Citizen-induced CPR with a 30:2 compression-ventilation ratio is superior to that with a 15:2 compression-ventilation ratio in terms of neurological benefit.
- © 2010 by American Heart Association, Inc.