Abstract 16132: Chest Compression Rates Between 100 and 120 per Minute are Independently Associated with Increased Adult Survival Following Out-of-Hospital Cardiac Arrest
Background: American Heart Association cardiopulmonary resuscitation (CPR) guidelines recommend a chest compression rate of at least 100 compressions/min, but provide no guidance for an upper rate limit.
Objective: To assess the relationship between chest compression rates used by emergency medical services (EMS) providers and survival to hospital discharge after out-of-hospital cardiac arrest (OHCA).
Methods: Adults (≥20 years) with OHCA treated by EMS providers were enrolled in the Resuscitation Outcomes Consortium (ROC) PRIMED study. Data were abstracted from monitor-defibrillator recordings for the first 5 minutes of CPR. Multiple logistic regression assessed the odds ratio (OR) for survival by compression rate categories (<80, 80 - 99, 100 - 119, 120 - 139, ≥140), unadjusted and adjusted OR for sex, age, witnessed status, attempted bystander CPR, location of arrest, chest compression fraction and depth, rhythm, and ROC site. We used a global test of association to assess significance.
Results: 10,371 patients with OHCA had CPR from June 2007 to November 2009 with compression rate available; 6,399 also had chest compression fraction and depth data. Mean age was 67 ± 16 years. Mean (± SD) compression rate was 111 ± 19 per minute, compression fraction was 0.66 ± 0.16, and compression depth was 42 ± 12 mm. Return of spontaneous circulation occurred in 34% and 9% survived to hospital discharge. The adjusted model (without chest compression depth and fraction) did not show a significant relationship between chest compression rate categories and survival (p = 0.19). However, in the subgroup of subjects with compression depth data the global test found a significant relationship between chest compression rate categories and survival, both with an adjustment for compression depth and fraction (p = 0.02) and without (p=0.02)(Table).
Conclusion: Survival to hospital discharge after OHCA is greater when chest compression rates are maintained in a range of 100 to 120/minute.
- © 2012 by American Heart Association, Inc.