Abstract 267: Chest-Compression-Only and Conventional Cardiopulmonary Resuscitation by Bystanders for Out-of-Hospital Cardiac Arrests With Public Access Defibrillation: A Prospective, Nationwide, Population-Based Cohort Study
Objectives: Previous animal and clinical studies suggest that chest compression-only cardiopulmonary resuscitation (CPR) by bystanders may be superior to conventional CPR for out-of-hospital cardiac arrests (OHCAs) of short duration. We aimed to evaluate the effectiveness of chest compression-only and conventional CPR by bystanders for patients with OHCA who received public access defibrillation (PAD) by use of automated external defibrillator (AED).
Methods: A nationwide, prospective, population-based observational study covering the whole population of Japan and involving consecutive OHCA patients with emergency responder resuscitation attempts has been conducted from 2005. We enrolled all OHCAs of presumed cardiac etiology in adults (≥18 years old) that were witnessed and received PAD-AED shocks by laypersons in Japan from 2005 through 2008. The main outcome measure was one-month survival with favorable neurological outcome. We compared outcomes by type of CPR by bystanders (chest compression-only / chest compression plus rescue breathing / no). Multivariable logistic regression was used to evaluate the relationship between type of CPR and better neurological outcome.
Results:During the 4-years, 914 OHCA cases of cardiac origin were witnessed and received PAD-AED shocks by laypersons. Among the 914 cardiac arrests, 265 received chest compression-only CPR and 569 received conventional CPR by bystanders. Although one-month survival with favorable neurological outcome was higher than no bystander CPR (31.3% [25/80]) regardless of type of CPR, chest compression-only CPR yielded a much higher rate of one-month survival with favorable neurological outcome (38.9% [103/265]) compared with conventional CPR (33.2% [189/569]) (Table).
Conclusions: Chest-compression-only CPR by bystanders would be a preferable approach for OHCAs who are treated with PAD-AEDs.
- © 2010 by American Heart Association, Inc.