Abstract 289: The Relationship of Chest Compression Rate and Survival During Out-of-Hospital Cardiopulmonary Resuscitation at Resuscitation Outcomes Consortium (ROC) Regional Sites
Background: Current American Heart Association guidelines for cardiopulmonary resuscitation (CPR) recommend a chest compression rate of at least 100 compressions/min. Animal and human CPR studies have reported improved blood flow associated with chest compressions rates ≥ 120/min, but few have reported rates used during out-of-hospital (OOH) CPR, or the relationship between rate and outcome.
Objective: To describe chest compression rates used by emergency medical services (EMS) providers to resuscitate patients with OOH cardiac arrest and to determine the relationship between rate and outcome.
Methods: Included were patients ≥ 20 years old enrolled in the ROC PRIMED study with OOH cardiac arrest treated by EMS providers. Data were abstracted from monitor-defibrillator recordings during the first 5 minutes of CPR. Multiple logistic regression assessed the association between chest compression rate and outcome. The model adjusted for sex, age, bystander and EMS witnessed arrest, attempted bystander CPR, public location, and ROC site.
Results: 10,330 patients had OOH CPR from June 2007 to November 2009. Mean age was 67 ± 16. Mean chest compression rate was 111 ± 19 (3 - 210) compressions/min during the first 5 minutes of CPR. Return of spontaneous circulation occurred in 34% and 9% survived to hospital discharge. Compared with the reference rate (100-120/min) (mean 109 ± 6), the adjusted odds ratios (OR) for survival were: compression rate from 0 - 80/min (mean 68 ± 13) OR 1.18 (CI 0.78 - 1.77), 80 - 100/min (mean 93 ± 5) OR 0.88 (0.73 - 1.06), 120 - 140/min (mean 128 ± 5) OR 0.88 (CI 0.73 - 1.08), >140/min (mean 151 ± 11) OR 0.77 (CI 0.54 - 1.11). A cubic spline curve suggests survival peaks at about 120/min and then declines at rates >120/min.
Conclusion: Chest compression rates faster than 100/min were common. The study suggests that the likelihood of survival from OOH cardiac arrest is decreased with compression rates >120/min.
- © 2011 by American Heart Association, Inc.