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Chest Compression Alone May Be More Effective For CPR

Recommendations for out-of-hospital cardiac arrest should be revised

FRIDAY, March 16 (HealthDay News) -- When bystanders attempt to resuscitate people who have had an out-of-hospital cardiac arrest, cardiac-only resuscitation is more effective on its own than with the mouth-to-mouth resuscitation that is currently the standard procedure for cardiopulmonary resuscitation (CPR), according to a study published in the March 17 issue of The Lancet.

Ken Nagao, M.D., of Surugadai Nihon University Hospital in Tokyo, Japan, and colleagues conducted a study of 4,068 adults who had experienced cardiac arrest in an out-of-hospital environment, of whom 439 (11 percent) were given cardiac-only resuscitation by bystanders, which consisted of chest compressions only, 712 (18 percent) were given conventional CPR and 2,917 (72 percent) did not receive any resuscitation.

While 5 percent of those who received any kind of resuscitation had a favorable neurological outcome versus 2.2 percent for those who did not, cardiac-only resuscitation produced the best results and the study found no evidence of benefit from mouth-to-mouth resuscitation.

The findings were especially striking for patients with apnea (90 percent of the subjects) with a 6.2 percent favorable neurological outcome with cardiac-only resuscitation versus 3.1 percent with CPR. The corresponding figures for subjects with shockable rhythm and those who received resuscitation within four minutes of arrest were 19.4 percent versus 11.2 percent, and 10.1 percent versus 5.1 percent, respectively.

"Time spent on mouth-to-mouth ventilation takes precious time away from chest compressions that support cerebral and coronary perfusion," the authors conclude.

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