#CHEST COMPRESSION RATE TRIAL#

1 - 7 Recovery with good neurologic function after out-of-hospital cardiac arrest (OHCA) is well-correlated with target ranges of chest compression rate (CCR) and chest compression depth (CCD). In recent clinical reports regarding cardiac arrest outcomes after closed-chest cardiopulmonary resuscitation (CPR), 1 factor strongly associated with worse outcomes has been inadequate performance of chest compressions. The results merit further investigation and prospective validation. The identified optimal CCR-CCD was associated with significantly higher probabilities of survival when the CPR device was used compared with standard CPR (odds ratio, 1.90 95% CI, 1.06-3.38 P = .03), and the device’s effectiveness was dependent on being near the target CCR-CCD combination.Ĭonclusions and Relevance The findings suggest that the combination of 107 compressions per minute and a depth of 4.7 cm is associated with significantly improved outcomes for out-of-hospital cardiac arrest. The optimal CCR-CCD combination remained similar regardless of age, sex, presenting cardiac rhythm, or CPR adjunct use. When CPR was performed within 20% of this value, survival probability was significantly higher (6.0% vs 4.3% outside that range odds ratio, 1.44 95% CI, 1.07-1.94 P = .02). The identified optimal CCR-CCD for all patients was 107 compressions per minute and a depth of 4.7 cm. Main Outcomes and Measures The optimal combination of CCR-CCD associated with functionally favorable survival (modified Rankin scale ≤3) overall and by age, sex, presenting cardiac rhythm, and CPR adjunct use. Interventions Standard out-of-hospital cardiac arrest interventions compliant with the concurrent American Heart Association guidelines as well as use of the CPR adjunct device in half of the patients. Data analysis was performed from September to November 2018. Subgroup analyses included evaluations according to age, sex, presenting cardiac rhythm, and application of a CPR adjunct.

#CHEST COMPRESSION RATE TRIAL#

The study sample included 3643 patients who had out-of-hospital cardiac arrest and for whom CCR and CCD had been simultaneously recorded during an NIH clinical trial of a CPR adjunct. Objectives To identify an ideal CCR-CCD combination associated with the highest probability of functionally favorable survival and to assess whether this combination varies with respect to age, sex, presenting cardiac rhythm, or CPR adjunct use.ĭesign, Setting, and Participants This cohort study used data collected between June 2007 and November 2009 from a National Institutes of Health (NIH) clinical trials network registry of out-of-hospital and in-hospital emergency care provided by 9-1-1 system agencies participating in the network across the United States and Canada (n = 150). However, an optimal CCR-CCD combination has yet to be identified, particularly with respect to age, sex, presenting cardiac rhythm, and CPR adjunct use. Importance Previous studies of basic cardiopulmonary resuscitation (CPR) indicate that both chest compression rate (CCR) and chest compression depth (CCD) each are associated with survival probability after out-of-hospital cardiac arrest. Meaning The findings suggest that the combination of 107 compressions per minute and a depth of 4.7 cm may be the optimal target for chest compression rate and depth, and that use of an adjunct may be associated with significantly enhanced outcomes if this target is used. Adjunct use was associated with significant improvements in outcome, but this was dependent on delivering the identified optimal chest compression rate and depth combination. Question During cardiopulmonary resuscitation, is there an optimal combination of chest compression rate and depth associated with an enhanced likelihood of favorable functional outcome, and does that optimal combination change with respect to age, sex, presenting cardiac rhythm, or use of a cardiopulmonary resuscitation adjunct?įindings In this cohort study of data from 3643 individuals in the National Institutes of Health clinical trials network database, the optimal combination of chest compression rate was 107 compressions per minute and chest compression depth of 4.7 cm this finding remained relatively consistent regardless of age, sex, presenting cardiac rhythm, or cardiopulmonary resuscitation adjunct use. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.

Challenges in Clinical Electrocardiography.

Chest compression rate