Chest-compression-only beneficial for out-of-hospital cardiac arrest

January 01, 0001

Chest-compression-only beneficial for out-of-hospital cardiac arrest

In out-of-hospital cardiac arrest, dispatcher- assisted chest-compression-only bystander CPR might be superior to standard bystander CPR (chest compression plus rescue ventilation), but trial findings have not shown significantly improved outcomes. The researchers from Austria and the USA aimed to establish the association of chest- compression-only CPR with survival in patients with out-of- hospital cardiac arrest. Medline and Embase were systematically reviewed for studies published between January, 1985, and August, 2010, in which chest-compression-only bystander CPR was compared with standard bystander CPR for adult patients with out-of-hospital cardiac arrest. In the primary meta- analysis, they included trials in which patients were randomly allocated to receive one of the two CPR techniques, according to dispatcher instructions; and in the secondary meta-analysis, they included observational cohort studies of chest-compression- only CPR. All studies had to supply survival data. The primary outcome was survival to hospital discharge.

In the primary meta-analysis, pooled data from three randomised trials showed that chest-compression-only CPR was associated with improved chance of survival compared with standard CPR (14% vs 12%; risk ratio 1.22). The absolute increase in survival was 2.4%, and the number needed to treat was 41. In the secondary meta-analysis of seven observational cohort studies, no difference was recorded between the two CPR techniques (8% vs 8%).

The researchers concluded: "For adults with out- of-hospital cardiac arrest, instructions to bystanders from emergency medical services dispatch should focus on chest- compression-only CPR."

This is being found by a number of studies following this meta-analysis.

For the full abstract, click here.

The Lancet published online 15 October 2010 © 2010 Elsevier Limited
Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis. Michael Hüpfl, Harald F Selig, Peter Nagele. Correspondence to Peter Nagele: [email protected]

Category: K. Circulatory. Keywords: chest, compression, cardiopulmonary, resuscitation, meta-analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 29 October 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.