CPR Pre-Heart Rhythm Analysis Does Not Affect Outcomes

And use of active impedance threshold device during CPR in cardiac arrest does not improve survival

WEDNESDAY, Aug. 31 (HealthDay News) -- For patients with out-of-hospital cardiac arrest, the outcome of a brief period of cardiopulmonary resuscitation (CPR) with early rhythm analysis is similar to that of a longer period of CPR with delayed rhythm analysis; and the use of an impedance threshold device (ITD) during standard CPR does not significantly improve survival with satisfactory function, according to two studies published in the Sept. 1 issue of the New England Journal of Medicine.

Ian G. Stiell, M.D., from the University of Ottawa, and colleagues compared the strategy of a brief period of CPR with early rhythm analysis with that of a longer period of CPR with delayed rhythm analysis in 9,933 patients with out-of-hospital cardiac arrest. The emergency medical service-administered CPR before the initial electrocardiographic analysis was 30 to 60 seconds in participants randomly assigned to early-analysis, and 180 seconds for those assigned to the later-analysis group. A total of 5.9 percent of the patients in each group survived to hospital discharge with satisfactory function, with neither study group showing survival benefit upon subgroup analyses or adjustment for confounding factors.

Tom P. Aufderheide, M.D., from the Medical College of Wisconsin in Milwaukee, and colleagues compared the use of an active ITD with that of a sham ITD in 8,718 patients with out-of-hospital cardiac arrest who underwent standard CPR. A total of 6.0 and 5.8 percent of the patients survived to hospital discharge with satisfactory function in the sham-ITD and active-ITD group, respectively.

"Use of the ITD did not significantly improve survival with satisfactory function among patients with out-of-hospital cardiac arrest receiving standard CPR," Aufderheide and colleagues write.

Several authors of both studies disclosed financial relationships with the medical device industry.

Full Text - Stiell (subscription or payment may be required)
Full Text - Aufderheide (subscription or payment may be required)
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