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January 19, 2005
Elizabeth Vall Reports
New CPR method improves results 500%
Giving mouth-to-mouth, is never anyone's favorite part of
CPR, but, now two University of Arizona physicians say it's
a dangerous waste of time.
In an article printed in Wednesday's journal of the
American Medical Association, heart experts at UA, say
national standards should no longer require mouth-to-mouth
ventilation for adults suffering cardiac arrest.
New studies show fast and forceful chest compressions are
more valuable. Doctors say it moves oxygenated blood to the
brain and heart, sustaining the body for up to ten minutes.
Dr. Arthur Sanders from the Sarver Heart Center, says We
improved survival from 13% for people receiving
ventilation and compression, to 80% survival rate where
they were getting continuous chest compressions.
Tucson firefighters and paramedics are trained to give
consistent compression CPR. Yet, every year, the American
Red Cross trains 20,000 citizens on the old method.
It's a more complicated combination of 15 compressions for
every two mouth to mouth breaths.
Richard White from the Southern Arizona Red Cross says,
They are learing tried and true tested techniques
internationaly respected that have been saving lives for
more than 50 years.
The Red Cross and the American Heart Association will be
reviewing this new research to see if national CPR
standards should be revised. The Red Cross says it's
possible changes could be made by 2006.
--
Circulation. 2002 Feb 5;105(5):645-9.
Importance of continuous chest compressions during
cardiopulmonary resuscitation: improved outcome during a
simulated single lay-rescuer scenario.
Kern KB, Hilwig RW, Berg RA, Sanders AB, Ewy GA.
University of Arizona Sarver Heart Center, Section of
Cardiology, 85724, USA. [EMAIL PROTECTED]
BACKGROUND: Interruptions to chest compression-generated
blood flow during cardiopulmonary resuscitation (CPR) are
detrimental. Data show that such interruptions for
mouth-to-mouth ventilation require a period of rebuilding
of coronary perfusion pressure to obtain the level achieved
before the interruption. Whether such hemodynamic
compromise from pausing to ventilate is enough to affect
outcome is unknown.
METHODS AND RESULTS: Thirty swine (weight 35 +/- 2 kg)
underwent 3 minutes of untreated ventricular fibrillation
before 12 minutes of basic life support CPR. Animals were
randomized to receive either standard airway (A), breathing
(B), and compression (C) CPR with expired-gas ventilation
in a 15:2 compression-to-ventilation ratio or continuous
chest compression CPR. Those randomized to the standard
15:2 group had no chest compressions for a period of 16
seconds each time the 2 ventilations were delivered.
Defibrillation was attempted at 15 minutes of cardiac
arrest. All resuscitated animals were supported in an
intensive care environment for 1 hour, then in a
maintenance facility for 24 hours. The primary end point of
neurologically normal 24-hour survival was significantly
better in the experimental group receiving continuous chest
compression CPR (12 of 15 versus 2 of 15; P0.0001).
CONCLUSIONS: Mouth-to-mouth ventilation performed by single
layperson rescuers produces substantial interruptions in
chest compression-supported circulation. Continuous chest
compression CPR produces greater neurologically normal
24-hour survival than standard ABC CPR when performed in a
clinically realistic fashion. Any technique that minimizes
lengthy interruptions of chest compressions during the
first 10 to 15 minutes of basic life support should be
given serious consideration in future efforts to improve
outcome results from cardiac arrest.
Resuscitation. 2004 Aug;62(2):219-27.
Continuous intratracheal insufflation of oxygen improves
the efficacy of mechanical chest compression-active
decompression CPR.
Steen S, Liao Q, Pierre L, Paskevicius A, Sjoberg T.
Department of Cardiothoracic Surgery, Heart-Lung Division,
University Hospital of Lund, SE-221 85 Lund, Sweden.
[EMAIL PROTECTED]
The aim of the present study was to compare the efficacy of
intratracheal continuous insufflation of oxygen (CIO) with
intermittent positive pressure ventilation (IPPV) regarding
gas exchange and haemodynamics during mechanical chest
compression-active decompression cardiopulmonary
resuscitation (mCPR) provided by the LUCAS device.
Ventricular fibrillation (VF) was induced electrically and
ventilation was discontinued in 16 pigs, mean body weight
23 kg (range 22-27 kg). They were randomized into two
groups (CIO versus IPPV). After 8 min of VF, mCPR was
started and run for 30 min in normothermia, after which
defibrillation was attempted during on-going mCPR. Return
of spontaneous circulation was obtained in eight of eight
CIO pigs and in four of eight IPPV pigs.
