New Form of CPR Improves Survival Rates

Emergency medical personnel using a new form of cardiopulmonary resuscitation (CPR) increased survival rates three-fold when facing the most common form of cardiac arrest.

The new approach, called cardiocerebral resuscitation, was developed at the University of Arizona Sarver Heart Center (Tucson, Arizona, USA), and is dramatically different from guideline-directed CPR procedures. Under the new approach, first responders skipped the first steps of the standard protocol: intubating the patient for ventilation and delivering a shock using a defibrillator. While still attaching the victim to a defibrillator, they did not wait for the device to analyze the patient's heart rhythm, but started fast, forceful chest compressions. The experiences of the response teams after the revised protocol were implemented in two Wisconsin counties, involving 125 patients, was published in the April 2006 issue of the American Journal of Medicine.

First responders applying the new protocol were able to resuscitate the majority (58%) of out-of-hospital witnessed cardiac arrest victims. In contrast, the survival rate was only 20% in the three years before, when the standard CPR protocol was used.

"In laboratory experiments, we found that the most important factor of survival is to keep the blood moving through the body by continuous chest compressions,” said Gordon A. Ewy, M.D., director of the Sarver Heart Center and co-author of the study. "Stopping chest compressions for ventilations was far more harmful than helpful. Excessive ventilations during chest compression turned out to be harmful, too.”

"We think one of the reasons that CPR as directed by international guidelines has not worked well is because it is designed for two entirely different conditions: cardiac arrest and respiratory arrest,” continued Dr. Ewy. "What is good for one may not be good for the other. Cardiocerebral resuscitation is designed for cardiac arrest. Sudden unexpected collapse in an adult is almost always due to cardiac arrest. The new approach is not recommended for respiratory arrest, a much less common situation following, for example, drowning or drug overdose.”



Related Links:
The University of Arizona Sarver Heart Center