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To ventilate or not to ventilate during bystander CPR - A EuReCa TWO analysis
J. Wnent, I. Tjelmeland, R. Lefering, RW. Koster, H. Maurer, S. Masterson, J. Herlitz, BW. Böttiger, FR. Ortiz, GD. Perkins, L. Bossaert, M. Moertl, P. Mols, I. Hadžibegović, A. Truhlář, A. Salo, V. Baert, E. Nagy, G. Cebula, V. Raffay, S....
Language English Country Ireland
Document type Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Cardiopulmonary Resuscitation * MeSH
- Humans MeSH
- Survival Rate MeSH
- Registries MeSH
- Emergency Medical Services * MeSH
- Ventilation MeSH
- Out-of-Hospital Cardiac Arrest * therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). METHOD: In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. RESULTS: A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17-1.83). CONCLUSION: In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both.
Centre for Clinical Research Dalarna Uppsala University S 79182 Falun Sweden
Department of Anaesthesiology and Intensive Care Medicine University Hospital of Cologne Germany
Department of Cardiology Amsterdam UMC Location Academic Medical Center Amsterdam The Netherlands
Department of Prehospital Care Region of Dalarna S 79129 Falun Sweden
Division of Prehospital Services Oslo University Hospital Norway
Emergency Medical Services of the Hradec Králové Region Hradec Králové Czech Republic
European Resuscitation Council Niel Belgium
European University Cyprus School of Medicine Nicosia Cyprus
Faculty of Medicine Institute of Clinical Medicine University of Oslo Norway
Hungarian Resuscitation Council
Jagiellonian University Medical College Department of Medical Education Poland
Medical Intensive Care Unit University Medical Centre Maribor Maribor Slovenia
Medical University of Innsbruck Department of Anaesthesia and Intensive Care Innsbruck Austria
National Ambulance Service and National University of Ireland Galway Ireland
School of Education Health and Social Studies Dalarna University S 79188 Falun Sweden
Serbian Resuscitation Council Novi Sad Serbia
Servicio de Urgencias y Emergencias 061 de La Rioja Spain
Slovenian Resuscitation Council Slovenian Society for Emergency Medicine Ljubljana Slovenia
University Hospital Schleswig Holstein Institute for Emergency Medicine Kiel Germany
University Hospitals Birmingham NHS Foundation Trust Birmingham United Kingdom
University of Antwerp Antwerp Belgium
University of Namibia School of Medicine Windhoek Namibia
Warwick Clinical Trials Unit Warwick Medical School University of Warwick Coventry United Kingdom
References provided by Crossref.org
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- $a BACKGROUND: Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). METHOD: In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. RESULTS: A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17-1.83). CONCLUSION: In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both.
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