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Title: Chest Compression–Only Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest With Public-Access Defibrillation : A Nationwide Cohort Study
Authors: Iwami, Taku  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-4150-7065 (unconfirmed)
Kitamura, Tetsuhisa
Kawamura, Takashi  kyouindb  KAKEN_id
Mitamura, Hideo
Nagao, Ken
Takayama, Morimasa
Seino, Yoshihiko
Tanaka, Hideharu
Nonogi, Hiroshi
Yonemoto, Naohiro
Kimura, Takeshi  kyouindb  KAKEN_id
Author's alias: 石見, 拓
Keywords: cardiopulmonary resuscitation
death, sudden
defibrillators
epidemiology
heart arrest
Issue Date: 11-Dec-2012
Publisher: American Heart Association
Journal title: Circulation
Volume: 126
Issue: 24
Start page: 2844
End page: 2851
Abstract: [Background]It remains unclear which is more effective to increase survival after out-of-hospital cardiac arrest in those with public-access defibrillation, bystander-initiated chest compression–only cardiopulmonary resuscitation (CPR) or conventional CPR with rescue breathing. [Methods and Results]A nationwide, prospective, population-based observational study covering the whole population of Japan and involving consecutive out-of-hospital cardiac arrest patients with resuscitation attempts has been conducted since 2005. We enrolled all out-of-hospital cardiac arrests of presumed cardiac origin that were witnessed and received shocks with public-access automated external defibrillation (AEDs) by bystanders from January 1, 2005, to December 31, 2009. The main outcome measure was neurologically favorable 1-month survival. We compared outcomes by type of bystander-initiated CPR (chest compression–only CPR and conventional CPR with compressions and rescue breathing). Multivariable logistic regression was used to assess the relationship between the type of CPR and a better neurological outcome. During the 5 years, 1376 bystander-witnessed out-of-hospital cardiac arrests of cardiac origin in individuals who received CPR and shocks with public-access AEDs by bystanders were registered. Among them, 506 (36.8%) received chest compression–only CPR and 870 (63.2%) received conventional CPR. The chest compression–only CPR group (40.7%, 206 of 506) had a significantly higher rate of 1-month survival with favorable neurological outcome than the conventional CPR group (32.9%, 286 of 870; adjusted odds ratio, 1.33; 95% confidence interval, 1.03–1.70). [Conclusions]Compression-only CPR is more effective than conventional CPR for patients in whom out-of-hospital cardiac arrest is witnessed and shocked with public-access defibrillation. Compression-only CPR is the most likely scenario in which lay rescuers can witness a sudden collapse and use public-access AEDs.
Rights: © 2012 American Heart Association, Inc.
URI: http://hdl.handle.net/2433/187271
DOI(Published Version): 10.1161/CIRCULATIONAHA.112.109504
Appears in Collections:Journal Articles

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