Monday, September 23, 2013

Simple CPR Could Have Long-Term Benefit!

CPR (Cardiopulmonary resuscitation) is an emergency procedure for a person who has cardiac arrest. Its purpose is to preserve intact brain function until further measures to restore spontaneous blood circulation and breathing. A standard CPR normally involves chest compression together mouth-to-mouth or mouth-to-nose resuscitation.

However, researchers from Descartes University in Paris, France and other institutions from Seattle (USA) and Sweden reported that people suffering cardiac arrest were less likely to die in subsequent years when bystanders performed simple CPR with chest compressions only. The findings were published online on December 10, 2012 in the journal ‘Circulation’.

This was more or less in line with the recommendation by the American Heart Association (AHA): a simpler form of CPR from bystanders is better than no aid at all. However, such recommendation does not apply to CPR performed in hospital or in community by medical personnel or people who are proficient in rescue breathing. Such recommendation also applies only to adult victims.

Data from 2 randomized trials that were reported in the ‘New England Journal of Medicine’ in 2010 were examined. More than 3,200 adults were involved. These victims had cardiac arrest likely due to heart disease problems rather than trauma, suffocating or drowning. Bystanders were instructed by dispatchers via phone to use either the standard or compression only form of CPR.

The researchers were able to follow 78 percent of the participants on longer-term outcomes. The one-year survival rate was found to be about 12 percent for chest compression alone and about 10 percent for standard CPR. Mortality was 9 percent lower in the compression-only group than in the standard CPR group, after adjusting for different factors. The survival benefit persisted over 5 years.

Nevertheless, the study only tracked survival and it could not assess patients’ function level or quality of life. Moreover, the original trials employed in the study were not meant for tracking long-term outcomes.

While there are concerns that victims who collapse of non-cardiac causes might not get the oxygen they need with the compression-only approach, the researchers confirmed they did not observe evidence of harm among those for whom oxygenation and ventilation might in theory be more important.

Victims would require fresh oxygen through mouth-to-mouth resuscitation only if they have been down for a longer or unknown period of time, according to other health experts. The majority of cardiac arrest events are likely caused by heart disease problems. It is most probably that some oxygen still remains in the blood when the victim’s heart has stopped for a short period of time. So proceeding with chest compression only should be beneficial for most circumstances.

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