Chest compression depth and survival in out-of-hospital cardiac arrest.

TitleChest compression depth and survival in out-of-hospital cardiac arrest.
Publication TypeJournal Article
Year of Publication2014
AuthorsVadeboncoeur T, Stolz U, Panchal A, Silver A, Venuti M, Tobin J, Smith G, Nunez M, Karamooz M, Spaite D, Bobrow B
Date Published2014 Feb
ISSN Number1873-1570
KeywordsAged, Arizona, Cardiopulmonary Resuscitation, Data Collection, Emergency Medical Services, Female, Heart Massage, Humans, Male, Middle Aged, Out-of-Hospital Cardiac Arrest, Prospective Studies, Survival Rate, Treatment Outcome

AIM: Outcomes from out-of-hospital cardiac arrest (OHCA) may improve if rescuers perform chest compressions (CCs) deeper than the previous recommendation of 38-51mm and consistent with the 2010 AHA Guideline recommendation of at least 51mm. The aim of this study was to assess the relationship between CC depth and OHCA survival.

METHODS: Prospective analysis of CC depth and outcomes in consecutive adult OHCA of presumed cardiac etiology from two EMS agencies participating in comprehensive CPR quality improvement initiatives.

ANALYSIS: Multivariable logistic regression to calculate adjusted odds ratios (aORs) for survival to hospital discharge and favorable functional outcome.

RESULTS: Among 593 OHCAs, 136 patients (22.9%) achieved return of spontaneous circulation, 63 patients (10.6%) survived and 50 had favorable functional outcome (8.4%). Mean CC depth was 49.8±11.0mm and mean CC rate was 113.9±18.1CCmin(-1). Mean depth was significantly deeper in survivors (53.6mm, 95% CI: 50.5-56.7) than non-survivors (48.8mm, 95% CI: 47.6-50.0). Each 5mm increase in mean CC depth significantly increased the odds of survival and survival with favorable functional outcome: aORs were 1.29 (95% CI 1.00-1.65) and 1.30 (95% CI 1.00-1.70) respectively.

CONCLUSION: Deeper chest compressions were associated with improved survival and functional outcome following OHCA. Our results suggest that adhering to the 2010 AHA Guideline-recommended depth of at least 51mm could improve outcomes for victims of OHCA.

Alternate JournalResuscitation
PubMed ID24125742
Faculty Reference: 
Bentley J. Bobrow, MD, FACEP, FAHA
Daniel W. Spaite, MD