Article : Compression Rate Matters for Out-of-Hospital...

Compression Rate Matters for Out-of-Hospital Cardiac Arrest

Faster is better, but only up to a point.

Current U.S. guidelines for cardiopulmonary resuscitation (CPR) recommend a compression rate of at least 100 per minute. In a multisite North American observational study, researchers measured chest compression rates used by emergency medical technicians and evaluated the association between compression rate and return of spontaneous circulation (ROSC) and survival to hospital discharge. Patients with out-of-hospital cardiac arrest were enrolled between 2005 and 2007, when the recommended compression rate was "about 100" per minute.

Compressions were measured within the first five minutes of CPR either by an accelerometer placed on the chest or the change in impedance recorded by external defibrillator pads. Two rates were calculated: (1) the number of compressions performed per minute during periods of continuous compressions, and (2) the number of compressions performed during 1-minute periods that included pauses.

Among 3098 patients, the mean compression rate was 112, and the mean delivered-compression rate was 74. Compression rate was associated with ROSC: the probability of ROSC peaked at a compression rate of 120 and declined at higher rates, most likely because compression depth decreased as rate increased. Compression rate was not associated with survival to discharge. Findings were similar for delivered-compression rate: a rate of <75 was associated with lower probability of ROSC, but rate had no effect on survival to hospital discharge.

Citation(s):

Idris AH et al. Relationship between chest compression rates and outcomes from cardiac arrest. Circulation 2012 Jun 19; 125:3004.

Nolan JP et al. Chest compression rate: Where is the sweet spot? Circulation 2012 Jun 19; 125:2968.

 

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