Chest Compression Rate: Where is the Sweet Spot?
The first description of modern cardiopulmonary resuscitation (CPR) included the instruction to compress the chest 'about 60 times per minute';1 however, the optimal compression rate was unknown. Franz Koenig is credited with describing the original technique for external cardiac massage, which included a compression rate of 30-40min1,2 But in the first published description of external cardiac massage in 1892, Friedrich Maass documented a better clinical response with a rate of 120 min1,2 To this day, the optimal compression rate is the subject of controversy. Animal data indicate that cardiac output increases with compression rates up to as high as 150 min1,3 In a canine model of prolonged cardiac arrest, compression rates of 120 min1 compared to 60 min1 increased mean aortic (systolic and diastolic) and coronary perfusion pressures, and 24 hour survival (61% versus 15%, P=0.03).4 In a study of nine patients undergoing CPR, a compression rate of 120 min1 generated higher aortic peak pressures and coronary perfusion pressures compared with a compression rate of 60 min1 (the rate recommended by the 1980 American Heart Association guidelines). This evidence is supported by another study of 23 patients in cardiac arrest in which compressions at 120 min1 resulted in significantly higher end-tidal carbon dioxide values compared with compressions at 80 min1,5. (SELECT FULL TEXT TO CONTINUE)
- Received May 14, 2012.
- Accepted May 16, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited