Short Attention Span Summary
“Stayin’ Alive”… “Shake it Off”… or “Hot Blooded”?
Target chest compression rate for CPR is 100 beats per minute. In this study of in-hospital cardiac arrest, “among 100-120, 121-140, and >140 compressions/min, ROSC was 29%, 64%, and 49% respectively.” The rate of 121-140 seemed to be the best.
Spoon Feed
Compression rates faster than the recommended 100-120 may result in improved ROSC. Whether that leads to improved long-term outcome remains to be seen. To give you an idea how fast that is, the Bee Gees “Stayin’ Alive” is 103 beats per minutes, and Taylor Swift’s “Shake it Off” is 160. Foreigner’s “Hot Blooded” hits the sweet spot at 130 beats per minute.
Abstract
Resuscitation. 2017 Jan;110:154-161. doi: 10.1016/j.resuscitation.2016.09.015. Epub 2016 Sep 22.
Kilgannon JH1, Kirchhoff M1, Pierce L2, Aunchman N1, Trzeciak S3, Roberts BW4.
Author information:
1The Department of Emergency Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, United States.
2The Department of Medicine, Division of Critical Care Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, United States.
3The Department of Emergency Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, United States; The Department of Medicine, Division of Critical Care Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, United States.
4The Department of Emergency Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, United States. Electronic address: [email protected].
Abstract
AIMS:
Recent guidelines for management of cardiac arrest recommend chest compression rates of 100-120 compressions/min. However, animal studies have found cardiac output to increase with rates up to 150 compressions/min. The objective of this study was to test the association between chest compression rates during cardiopulmonary resuscitation for in-hospital cardiac arrest (IHCA) and outcome.
METHODS:
We conducted a prospective observational study at a single academic medical center.
INCLUSION CRITERIA:
age≥18, IHCA, cardiopulmonary resuscitation performed. We analyzed chest compression rates measured by defibrillation electrodes, which recorded changes in thoracic impedance. The primary outcome was return of spontaneous circulation (ROSC). We used multivariable logistic regression to determine odds ratios for ROSC by chest compression rate categories (100-120, 121-140, >140 compressions/min), adjusted for chest compression fraction (proportion of time chest compressions provided) and other known predictors of outcome. We set 100-120 compressions/min as the reference category for the multivariable model.
RESULTS:
We enrolled 222 consecutive patients and found a mean chest compression rate of 139±15. Overall 53% achieved ROSC; among 100-120, 121-140, and >140 compressions/min, ROSC was 29%, 64%, and 49% respectively. A chest compression rate of 121-140 compressions/min had the greatest likelihood of ROSC, odds ratio 4.48 (95% CI 1.42-14.14).
CONCLUSIONS:
In this sample of adult IHCA patients, a chest compression rate of 121-140 compressions/min had the highest odds ratio of ROSC. Rates above the currently recommended 100-120 compressions/min may improve the chances of ROSC among IHCA patients.
Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
PMCID: PMC5167634 [Available on 2018-01-01]
PMID: 27666168 [PubMed – in process]
