Abstract 18053: Use of Cardiocerebral Resuscitation or AHA 2005 Guidelines by EMS Improves Survival from Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis
Background: The 2005 American Heart Association (AHA) Guidelines on CPR advise minimal interruptions in chest compressions during out-of-hospital cardiac arrest (OHCA). Growing evidence suggests that use of Cardiocerebral Resuscitation (CCR) - compressions without ventilations - may increase survival. To date, no systematic review has been conducted to assess the impact of implementing CCR or AHA 2005 guidelines.
Objective: To determine if Emergency Medical Services (EMS) implementation of CCR or AHA 2005 protocols improved patient outcomes from OHCA.
Methods: We conducted a systematic search of electronic databases (MEDLINE, EMBASE, CENTRAL) and consulted experts to identify all potential studies. A priori study inclusion criteria were: 1) used human OHCA subjects, 2) compared CCR or AHA 2005 guidelines to AHA 2000 guidelines, and 3) met AHA criteria for “Good” quality.
Results: We identified 681 potentially relevant articles. The 12 studies meeting inclusion criteria are shown with their data in Table 1. All 3 studies using CCR demonstrated improved survival compared to use of AHA 2000 guidelines, as did 5 out of the 9 studies using AHA 2005 guidelines. Pooled data demonstrates that use of a CCR protocol has an Odds Ratio of 2.25 (95% Confidence Interval [CI]: 1.81-2.79) for survival to hospital discharge among all cardiac arrest patients. Use of AHA 2005 Guidelines increases all patient survival by an OR of 1.39 (95% CI: 1.10-1.75).
Conclusion: Our systematic review and meta-analysis demonstrated improved survival from OHCA when EMS use CCR or AHA 2005 guidelines. Additional research is needed to further define the difference in outcomes between these two protocols.
- © 2011 by American Heart Association, Inc.