Chest compression depth and survival in out-of-hospital cardiac arrest

Tyler Vadeboncoeur, Uwe Stolz, Ashish Panchal, Annemarie Silver, Mark Venuti, John Tobin, Gary Smith, Martha Nunez, Madalyn Karamooz, Daniel W Spaite, Bentley J Bobrow

Research output: Contribution to journalArticle

137 Citations (Scopus)

Abstract

Aim: Outcomes from out-of-hospital cardiac arrest (OHCA) may improve if rescuers perform chest compressions (CCs) deeper than the previous recommendation of 38-51. mm and consistent with the 2010 AHA Guideline recommendation of at least 51. mm. The aim of this study was to assess the relationship between CC depth and OHCA survival. Methods: Prospective analysis of CC depth and outcomes in consecutive adult OHCA of presumed cardiac etiology from two EMS agencies participating in comprehensive CPR quality improvement initiatives. Analysis: Multivariable logistic regression to calculate adjusted odds ratios (aORs) for survival to hospital discharge and favorable functional outcome. Results: Among 593 OHCAs, 136 patients (22.9%) achieved return of spontaneous circulation, 63 patients (10.6%) survived and 50 had favorable functional outcome (8.4%). Mean CC depth was 49.8±11.0mm and mean CC rate was 113.9±18.1CCmin-1. Mean depth was significantly deeper in survivors (53.6mm, 95% CI: 50.5-56.7) than non-survivors (48.8mm, 95% CI: 47.6-50.0). Each 5mm increase in mean CC depth significantly increased the odds of survival and survival with favorable functional outcome: aORs were 1.29 (95% CI 1.00-1.65) and 1.30 (95% CI 1.00-1.70) respectively. Conclusion: Deeper chest compressions were associated with improved survival and functional outcome following OHCA. Our results suggest that adhering to the 2010 AHA Guideline-recommended depth of at least 51. mm could improve outcomes for victims of OHCA.

Original languageEnglish (US)
Pages (from-to)182-188
Number of pages7
JournalResuscitation
Volume85
Issue number2
DOIs
StatePublished - Feb 2014

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Out-of-Hospital Cardiac Arrest
Thorax
Survival
Odds Ratio
Guidelines
Cardiopulmonary Resuscitation
Quality Improvement
Survivors
Logistic Models

Keywords

  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Compression depth

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Chest compression depth and survival in out-of-hospital cardiac arrest. / Vadeboncoeur, Tyler; Stolz, Uwe; Panchal, Ashish; Silver, Annemarie; Venuti, Mark; Tobin, John; Smith, Gary; Nunez, Martha; Karamooz, Madalyn; Spaite, Daniel W; Bobrow, Bentley J.

In: Resuscitation, Vol. 85, No. 2, 02.2014, p. 182-188.

Research output: Contribution to journalArticle

Vadeboncoeur, T, Stolz, U, Panchal, A, Silver, A, Venuti, M, Tobin, J, Smith, G, Nunez, M, Karamooz, M, Spaite, DW & Bobrow, BJ 2014, 'Chest compression depth and survival in out-of-hospital cardiac arrest', Resuscitation, vol. 85, no. 2, pp. 182-188. https://doi.org/10.1016/j.resuscitation.2013.10.002
Vadeboncoeur, Tyler ; Stolz, Uwe ; Panchal, Ashish ; Silver, Annemarie ; Venuti, Mark ; Tobin, John ; Smith, Gary ; Nunez, Martha ; Karamooz, Madalyn ; Spaite, Daniel W ; Bobrow, Bentley J. / Chest compression depth and survival in out-of-hospital cardiac arrest. In: Resuscitation. 2014 ; Vol. 85, No. 2. pp. 182-188.
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AU - Vadeboncoeur, Tyler

AU - Stolz, Uwe

AU - Panchal, Ashish

AU - Silver, Annemarie

AU - Venuti, Mark

AU - Tobin, John

AU - Smith, Gary

AU - Nunez, Martha

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AU - Spaite, Daniel W

AU - Bobrow, Bentley J

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N2 - Aim: Outcomes from out-of-hospital cardiac arrest (OHCA) may improve if rescuers perform chest compressions (CCs) deeper than the previous recommendation of 38-51. mm and consistent with the 2010 AHA Guideline recommendation of at least 51. mm. The aim of this study was to assess the relationship between CC depth and OHCA survival. Methods: Prospective analysis of CC depth and outcomes in consecutive adult OHCA of presumed cardiac etiology from two EMS agencies participating in comprehensive CPR quality improvement initiatives. Analysis: Multivariable logistic regression to calculate adjusted odds ratios (aORs) for survival to hospital discharge and favorable functional outcome. Results: Among 593 OHCAs, 136 patients (22.9%) achieved return of spontaneous circulation, 63 patients (10.6%) survived and 50 had favorable functional outcome (8.4%). Mean CC depth was 49.8±11.0mm and mean CC rate was 113.9±18.1CCmin-1. Mean depth was significantly deeper in survivors (53.6mm, 95% CI: 50.5-56.7) than non-survivors (48.8mm, 95% CI: 47.6-50.0). Each 5mm increase in mean CC depth significantly increased the odds of survival and survival with favorable functional outcome: aORs were 1.29 (95% CI 1.00-1.65) and 1.30 (95% CI 1.00-1.70) respectively. Conclusion: Deeper chest compressions were associated with improved survival and functional outcome following OHCA. Our results suggest that adhering to the 2010 AHA Guideline-recommended depth of at least 51. mm could improve outcomes for victims of OHCA.

AB - Aim: Outcomes from out-of-hospital cardiac arrest (OHCA) may improve if rescuers perform chest compressions (CCs) deeper than the previous recommendation of 38-51. mm and consistent with the 2010 AHA Guideline recommendation of at least 51. mm. The aim of this study was to assess the relationship between CC depth and OHCA survival. Methods: Prospective analysis of CC depth and outcomes in consecutive adult OHCA of presumed cardiac etiology from two EMS agencies participating in comprehensive CPR quality improvement initiatives. Analysis: Multivariable logistic regression to calculate adjusted odds ratios (aORs) for survival to hospital discharge and favorable functional outcome. Results: Among 593 OHCAs, 136 patients (22.9%) achieved return of spontaneous circulation, 63 patients (10.6%) survived and 50 had favorable functional outcome (8.4%). Mean CC depth was 49.8±11.0mm and mean CC rate was 113.9±18.1CCmin-1. Mean depth was significantly deeper in survivors (53.6mm, 95% CI: 50.5-56.7) than non-survivors (48.8mm, 95% CI: 47.6-50.0). Each 5mm increase in mean CC depth significantly increased the odds of survival and survival with favorable functional outcome: aORs were 1.29 (95% CI 1.00-1.65) and 1.30 (95% CI 1.00-1.70) respectively. Conclusion: Deeper chest compressions were associated with improved survival and functional outcome following OHCA. Our results suggest that adhering to the 2010 AHA Guideline-recommended depth of at least 51. mm could improve outcomes for victims of OHCA.

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KW - Cardiopulmonary resuscitation

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