Two Studies Offer Support for Compression-Only CPR

For cardiac arrest patients, compression alone or with rescue breathing tied to similar survival rates
By Eric Metcalf
HealthDay Reporter

WEDNESDAY, July 28 (HealthDay News) -- Instructions from emergency dispatchers to give cardiopulmonary resuscitation (CPR) with chest compressions only or compressions with rescue breathing are associated with similar survival rates, according to two studies published in the July 29 New England Journal of Medicine.

Thomas D. Rea, M.D., of the Emergency Medical Services Division of Public Health for Seattle and King County, and colleagues analyzed data from 1,941 adults with out-of-hospital cardiac arrest; dispatchers randomly provided CPR directions to bystanders for compressions either alone or with rescue breathing. No significant differences were observed in the proportion of patients who survived to hospital discharge or survived with a favorable neurologic outcome. Compression alone was linked to a nonsignificant trend toward a higher proportion of patients surviving to hospital discharge for those with a cardiac cause of arrest or shockable rhythms.

Leif Svensson, M.D., of the Karolinska Institutet in Stockholm, Sweden, and colleagues analyzed data from 1,276 patients with suspected, witnessed, out-of-hospital cardiac arrest. Patients were randomly assigned to compression-only or standard CPR, with no significant differences seen in thirty-day survival.

"The straightforward conclusion from the primary analyses of these studies is that continuous chest compression without active ventilation, which is simpler to teach and perform, results in a survival rate similar to that with chest compression with rescue breathing," writes the author of an accompanying editorial. "Performance of mouth-to-mouth rescue breathing is far more difficult than proper chest compression, and rescue breathing may be viewed with distaste and raise concerns about risks associated with mouth-to-mouth contact."

The first study was supported in part by the Laerdal Foundation for Acute Medicine and the Medic One Foundation, and two co-authors reported personal or institutional relationships with Philips Medical Systems, Physio-Control, and Medtronic Foundation. The second study was supported by a grant from SOS Alarm, which employs a co-author.

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