Cardiocerebral Resuscitation Better than CPR

Cardiocerebral resuscitation has been found better than cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest, according to a new report.

Researchers from the University of Arizona Sarver Heart Center (Tucson, USA) examined data from Emergency Medical Services (EMS) in the Phoenix (AZ, USA) metropolitan area. The results showed that 9% of out-of-hospital cardiac arrest victims survived after the implementation of cardiocerebral resuscitation, which equals a 300% increase in survival compared to the 1-3% survival rate when using guideline CPR. The results were presented at the American Heart Association's 2006 scientific sessions, held in Chicago (IL, USA) in November 2006. The AHA guidelines prescribe that 30 chest compressions be delivered, followed by two mouth-to-mouth breaths. While the responder presses on the chest, oxygenated blood is moved through the body and delivered to the organs.

"But when you stop chest compressions to give mouth-to-mouth ventilations, no blood is moved and the organs essentially are starved,” said Gordon A. Ewy, M.D., director of Sarver Heart Center. "In fact, during CPR, blood flow to the brain and the organs is so poor that stopping chest compression for any reason--including so called ‘rescue breathing'--is not helpful.”

"We think CPR is not optimal because it is advocated as a ‘one-size-fits-all' approach, ignoring that cardiac arrest and respiratory arrest are two distinct pathophysiological conditions,” continued Dr. Ewy. "In out-of-hospital cardiac arrest, the brain and the heart need resuscitation, not the lungs.”

The new technique does away with mouth-to-mouth breathing and uses continuous chest compression, enhancing the willingness of lay individuals to perform resuscitation. Additionally, studies have shown that bystanders performing CPR take much longer to deliver rescue breaths between chest compressions than previously thought--an average of 16 instead of the presumed four seconds, which decreases oxygenation even further.



Related Links:
University of Arizona Sarver Heart Center