Relationship between chest compression rates and outcomes from cardiac arrest

Ahamed H. Idris, Danielle Guffey, Tom P. Aufderheide, Siobhan Brown, Laurie J. Morrison, Patrick Nichols, Judy Powell, Mohamud Daya, Blair L. Bigham, Dianne L. Atkins, Robert Berg, Dan Davis, Ian Stiell, George Sopko, Graham Nichol

Research output: Contribution to journalArticle

218 Citations (Scopus)

Abstract

Background-Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions per minute. Animal and human studies have reported that blood flow is greatest with chest compression rates near 120/min, but few have reported rates used during out-of-hospital (OOH) cardiopulmonary resuscitation or the relationship between rate and outcome. The purpose of this study was to describe chest compression rates used by emergency medical services providers to resuscitate patients with OOH cardiac arrest and to determine the relationship between chest compression rate and outcome. Methods and Results-Included were patients aged ≥20 years with OOH cardiac arrest treated by emergency medical services providers participating in the Resuscitation Outcomes Consortium. Data were abstracted from monitor-defibrillator recordings during cardiopulmonary resuscitation. Multiple logistic regression analysis assessed the association between chest compression rate and outcome. From December 2005 to May 2007, 3098 patients with OOH cardiac arrest were included in this study. Mean age was 67±16 years, and 8.6% survived to hospital discharge. Mean compression rate was 112±19/min. A curvilinear association between chest compression rate and return of spontaneous circulation was found in cubic spline models after multivariable adjustment (P=0.012). Return of spontaneous circulation rates peaked at a compression rate of ≈ 125/min and then declined. Chest compression rate was not significantly associated with survival to hospital discharge in multivariable categorical or cubic spline models. Conclusions-Chest compression rate was associated with return of spontaneous circulation but not with survival to hospital discharge in OOH cardiac arrest.

Original languageEnglish (US)
Pages (from-to)3004-3012
Number of pages9
JournalCirculation
Volume125
Issue number24
DOIs
StatePublished - Jun 19 2012

Fingerprint

Heart Arrest
Thorax
Out-of-Hospital Cardiac Arrest
Cardiopulmonary Resuscitation
Emergency Medical Services
Defibrillators
Survival
Resuscitation
Logistic Models
Regression Analysis
Guidelines

Keywords

  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Guidelines
  • Heart arrest
  • Outcomes research

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Idris, A. H., Guffey, D., Aufderheide, T. P., Brown, S., Morrison, L. J., Nichols, P., ... Nichol, G. (2012). Relationship between chest compression rates and outcomes from cardiac arrest. Circulation, 125(24), 3004-3012. https://doi.org/10.1161/CIRCULATIONAHA.111.059535

Relationship between chest compression rates and outcomes from cardiac arrest. / Idris, Ahamed H.; Guffey, Danielle; Aufderheide, Tom P.; Brown, Siobhan; Morrison, Laurie J.; Nichols, Patrick; Powell, Judy; Daya, Mohamud; Bigham, Blair L.; Atkins, Dianne L.; Berg, Robert; Davis, Dan; Stiell, Ian; Sopko, George; Nichol, Graham.

In: Circulation, Vol. 125, No. 24, 19.06.2012, p. 3004-3012.

Research output: Contribution to journalArticle

Idris, AH, Guffey, D, Aufderheide, TP, Brown, S, Morrison, LJ, Nichols, P, Powell, J, Daya, M, Bigham, BL, Atkins, DL, Berg, R, Davis, D, Stiell, I, Sopko, G & Nichol, G 2012, 'Relationship between chest compression rates and outcomes from cardiac arrest', Circulation, vol. 125, no. 24, pp. 3004-3012. https://doi.org/10.1161/CIRCULATIONAHA.111.059535
Idris AH, Guffey D, Aufderheide TP, Brown S, Morrison LJ, Nichols P et al. Relationship between chest compression rates and outcomes from cardiac arrest. Circulation. 2012 Jun 19;125(24):3004-3012. https://doi.org/10.1161/CIRCULATIONAHA.111.059535
Idris, Ahamed H. ; Guffey, Danielle ; Aufderheide, Tom P. ; Brown, Siobhan ; Morrison, Laurie J. ; Nichols, Patrick ; Powell, Judy ; Daya, Mohamud ; Bigham, Blair L. ; Atkins, Dianne L. ; Berg, Robert ; Davis, Dan ; Stiell, Ian ; Sopko, George ; Nichol, Graham. / Relationship between chest compression rates and outcomes from cardiac arrest. In: Circulation. 2012 ; Vol. 125, No. 24. pp. 3004-3012.
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abstract = "Background-Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions per minute. Animal and human studies have reported that blood flow is greatest with chest compression rates near 120/min, but few have reported rates used during out-of-hospital (OOH) cardiopulmonary resuscitation or the relationship between rate and outcome. The purpose of this study was to describe chest compression rates used by emergency medical services providers to resuscitate patients with OOH cardiac arrest and to determine the relationship between chest compression rate and outcome. Methods and Results-Included were patients aged ≥20 years with OOH cardiac arrest treated by emergency medical services providers participating in the Resuscitation Outcomes Consortium. Data were abstracted from monitor-defibrillator recordings during cardiopulmonary resuscitation. Multiple logistic regression analysis assessed the association between chest compression rate and outcome. From December 2005 to May 2007, 3098 patients with OOH cardiac arrest were included in this study. Mean age was 67±16 years, and 8.6{\%} survived to hospital discharge. Mean compression rate was 112±19/min. A curvilinear association between chest compression rate and return of spontaneous circulation was found in cubic spline models after multivariable adjustment (P=0.012). Return of spontaneous circulation rates peaked at a compression rate of ≈ 125/min and then declined. Chest compression rate was not significantly associated with survival to hospital discharge in multivariable categorical or cubic spline models. Conclusions-Chest compression rate was associated with return of spontaneous circulation but not with survival to hospital discharge in OOH cardiac arrest.",
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AU - Aufderheide, Tom P.

AU - Brown, Siobhan

AU - Morrison, Laurie J.

AU - Nichols, Patrick

AU - Powell, Judy

AU - Daya, Mohamud

AU - Bigham, Blair L.

AU - Atkins, Dianne L.

AU - Berg, Robert

AU - Davis, Dan

AU - Stiell, Ian

AU - Sopko, George

AU - Nichol, Graham

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N2 - Background-Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions per minute. Animal and human studies have reported that blood flow is greatest with chest compression rates near 120/min, but few have reported rates used during out-of-hospital (OOH) cardiopulmonary resuscitation or the relationship between rate and outcome. The purpose of this study was to describe chest compression rates used by emergency medical services providers to resuscitate patients with OOH cardiac arrest and to determine the relationship between chest compression rate and outcome. Methods and Results-Included were patients aged ≥20 years with OOH cardiac arrest treated by emergency medical services providers participating in the Resuscitation Outcomes Consortium. Data were abstracted from monitor-defibrillator recordings during cardiopulmonary resuscitation. Multiple logistic regression analysis assessed the association between chest compression rate and outcome. From December 2005 to May 2007, 3098 patients with OOH cardiac arrest were included in this study. Mean age was 67±16 years, and 8.6% survived to hospital discharge. Mean compression rate was 112±19/min. A curvilinear association between chest compression rate and return of spontaneous circulation was found in cubic spline models after multivariable adjustment (P=0.012). Return of spontaneous circulation rates peaked at a compression rate of ≈ 125/min and then declined. Chest compression rate was not significantly associated with survival to hospital discharge in multivariable categorical or cubic spline models. Conclusions-Chest compression rate was associated with return of spontaneous circulation but not with survival to hospital discharge in OOH cardiac arrest.

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KW - Outcomes research

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