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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 ![]() ![]() ![]() Kitamura, Tetsuhisa Kawamura, Takashi ![]() ![]() Mitamura, Hideo Nagao, Ken Takayama, Morimasa Seino, Yoshihiko Tanaka, Hideharu Nonogi, Hiroshi Yonemoto, Naohiro Kimura, Takeshi ![]() ![]() |
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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