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Title: Effectiveness of Bystander-Initiated Cardiac-Only Resuscitation for Patients With Out-of-Hospital Cardiac Arrest
Authors: Iwami, Taku  kyouindb  KAKEN_id  orcid (unconfirmed)
Kawamura, Takashi  KAKEN_id
Hiraide, Atsushi
Berg, Robert A.
Hayashi, Yasuyuki
Nishiuchi, Tatsuya
Kajino, Kentaro
Yonemoto, Naohiro
Yukioka, Hidekazu
Sugimoto, Hisashi
Kakuchi, Hiroyuki
Sase, Kazuhiro
Yokoyama, Hiroyuki
Nonogi, Hiroshi
Author's alias: 石見, 拓
Keywords: cardiopulmonary resuscitation
death, sudden
heart arrest
ventricular fibrillation
Issue Date: 18-Dec-2007
Publisher: American Heart Association
Journal title: Circulation
Volume: 116
Issue: 25
Start page: 2900
End page: 2907
Abstract: [Background] Previous animal and clinical studies suggest that bystander-initiated cardiac-only resuscitation may be superior to conventional cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrests. Our hypothesis was that both cardiac-only bystander resuscitation and conventional bystander CPR would improve outcomes from out-of-hospital cardiac arrests of ≤15 minutes' duration, whereas the addition of rescue breathing would improve outcomes for cardiac arrests lasting >15 minutes. [Methods and Results] We carried out a prospective, population-based, observational study involving consecutive patients with emergency responder resuscitation attempts from May 1, 1998, through April 30, 2003. The primary outcome measure was 1-year survival with favorable neurological outcome. Multivariable logistic regression analysis was performed to evaluate the relationship between type of CPR and outcomes. Among the 4902 witnessed cardiac arrests, 783 received conventional CPR, and 544 received cardiac-only resuscitation. Excluding very-long-duration cardiac arrests (>15 minutes), the cardiac-only resuscitation yielded a higher rate of 1-year survival with favorable neurological outcome than no bystander CPR (4.3% versus 2.5%; odds ratio, 1.72; 95% CI, 1.01 to 2.95), and conventional CPR showed similar effectiveness (4.1%; odds ratio, 1.57; 95% CI, 0.95 to 2.60). For the very-long-duration arrests, neurologically favorable 1-year survival was greater in the conventional CPR group, but there were few survivors regardless of the type of bystander CPR (0.3% [2 of 624], 0% [0 of 92], and 2.2% [3 of 139] in the no bystander CPR, cardiac-only CPR, and conventional CPR groups, respectively; P<0.05). [Conclusions] Bystander-initiated cardiac-only resuscitation and conventional CPR are similarly effective for most adult out-of-hospital cardiac arrests. For very prolonged cardiac arrests, the addition of rescue breathing may be of some help.
Rights: © 2007 American Heart Association, Inc.
DOI(Published Version): 10.1161/CIRCULATIONAHA.107.723411
PubMed ID: 18071072
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