Still, Cone, of Yale University, said it’s unknown if the same CCR-CCD combination would even be optimal for mechanically managed patients, since their machines don’t necessarily mimic human rescuers. Cone, MD, in a related editorial suggested the team try to replicate their results in patients managed with mechanical CPR devices, since those are “fairly exact and consistent” in their compression rate and depth. When a CPR device was used, victims were more likely to survive a cardiac arrest, though that benefit was dependent on being near the target CCR-CCD combination.Īsking how Duval et al.’s findings could be validated, David C. The combination remained optimal even after adjustment for age, sex, presenting cardiac rhythm or CPR adjunct use. They found that when CPR was performed within 20% of that value, survival probability was 44% higher (6% in patients who received the combo vs. The authors identified 107 compressions per minute at a depth of 4.7 centimeters as the optimum CCR-CCD combination, defined by functionally favorable survival. Of the study pool, nearly 65% were men and the mean age was 67.5 years old. “Knowing, monitoring and confirming target CCR-CCD combinations would not only optimize treatment but also improve the study design and reliability of clinical studies.”ĭuval’s team used data collected between June of 2007 and November of 2009 from a National Institutes of Health clinical trials network to study 3,643 patients who experienced out-of-hospital cardiac arrest and whose CCR and CCD values had been recorded at the time. “Data are still lacking with respect to specifically identifying the optimal combination of CCR and CCD and whether the same CCR-CCD target combination should be applied to all patients irrespective of sex, age, presenting cardiac rhythm or CPR adjunct use,” the authors wrote in JAMA. Clinical guidelines recommend a CCR of between 100 and 120 compressions per minute at a depth of 5 to 6 centimeters. It’s a delicate balance to strike-compressions that are too fast won’t allow for enough ventricular filling between compressions, and compressions that are too deep risk major thoracic injury.ĭuval, of the University of Minnesota Medical School, and colleagues said clinical reports have identified better neurologic outcomes and survival in cardiac arrest victims treated within “favorable” ranges of CCR and CCD, but those ranges were independently identified for each study. The purpose of Sue Duval, PhD, et al.’s study was to identify the ideal CCR-CCD combo for victims of out-of-hospital cardiac arrest, whose shot at survival hovers somewhere around 10%. AEDS or "automated external defibrillators," may also be important to helping meet this goal, helping to deliver verbal instructions to increase speed to help save more lives.A combination of 107 chest compressions per minute at a depth of 4.7 centimeters is the optimal CCR-CCD (chest compression rate-chest compression depth) ratio for survival after an out-of-hospital cardiac arrest, researchers reported August 14 in JAMA Cardiology. While this research was limited to those with in-hospital cardiac arrest, it will be important to study this among bystanders delivering CPR. The takeaway from this study is that speed matters, and medical providers should aim for at least two compressions every second. In simple terms, this means can a person speak clearly, understand and carry on a conversation and have a reasonable ability to walk and live among others in society. While the data indicates an improved ROSC, this unfortunately did not translate into better quality of life with a meaningful neurologic outcome.
Results from the study indicated that the rate of chest compressions was high (median, 140 per minute), with the average compression rate 100–120 per minute in 10% of patients, 121–140 in 43%, and greater than 140 in 47%.Ĭompared to patients who received compressions at the currently recommended rate of 100–120 per minute, patients with average rates of 121–140 were significantly more likely to have ROSC (64% to 29%).īut one caveat from the study is that there was no significant improvement in an important measure known as “survival to hospital discharge with intact neurological function.” The study indicated that the quality of CPR was excellent, with median time from a patient “found down” or collapsed to initiation of CPR logging at less than 1 minute. Researchers aimed to measure the association between the rate of compressions and return of spontaneous circulation (ROSC), survival and survival to discharge with intact neurological function. The compression rate was measured using defibrillation electrodes, while pauses in CPR (to check pulses and deliver ventilations) were not included in calculation of the net rate of compressions.
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