Compression depth measured by accelerometer vs. outcome in patients with out-of-hospital cardiac arrest.


Journal

Resuscitation
ISSN: 1873-1570
Titre abrégé: Resuscitation
Pays: Ireland
ID NLM: 0332173

Informations de publication

Date de publication:
10 2021
Historique:
received: 02 05 2021
revised: 24 06 2021
accepted: 04 07 2021
pubmed: 1 8 2021
medline: 3 11 2021
entrez: 31 7 2021
Statut: ppublish

Résumé

Analyses of data recorded by monitor-defibrillators that measure CPR depth with different methods show significant relationships between the process and outcome of CPR. Our objective was to evaluate whether chest compression depth was significantly associated with outcome based on accelerometer-recordings obtained with monitor-defibrillators from a single manufacturer, and to assess whether an accelerometer-based analysis corroborated evidence-based practice guidelines on performance of CPR. We included 5434 adult patients treated from seven US and Canadian cities between January 2007 and May 2015. These had mean (SD) age of 64.2 (17.2) years, mean compression depth of 45.9 (12.7) mm, ROSC sustained to ED arrival of 26%, and survival to hospital discharge of 8%. For survival to discharge, the adjusted odds ratios were 1.15 (95% CI, 0.86, 1.55) for cases within 2005 depth range (38-51 mm), and 1.17 (95% CI, 0.91, 1.50) for cases within 2010 depth range (>50 mm) compared to those with an average depth of <38 mm. The adjusted odds ratio of survival was 1.33 (95% CI, 1.01, 1.75) for cases within 2015 depth range (50 to 60 mm) for at least 60% of minutes. This analysis of patients with OHCA demonstrated that increased chest compression depth measured by accelerometer is associated with better survival. It confirms that current evidence-based recommendations to compress within 50-60 mm are likely associated with greater survival than compressing to another depth.

Sections du résumé

BACKGROUND
Analyses of data recorded by monitor-defibrillators that measure CPR depth with different methods show significant relationships between the process and outcome of CPR. Our objective was to evaluate whether chest compression depth was significantly associated with outcome based on accelerometer-recordings obtained with monitor-defibrillators from a single manufacturer, and to assess whether an accelerometer-based analysis corroborated evidence-based practice guidelines on performance of CPR.
METHODS AND RESULTS
We included 5434 adult patients treated from seven US and Canadian cities between January 2007 and May 2015. These had mean (SD) age of 64.2 (17.2) years, mean compression depth of 45.9 (12.7) mm, ROSC sustained to ED arrival of 26%, and survival to hospital discharge of 8%. For survival to discharge, the adjusted odds ratios were 1.15 (95% CI, 0.86, 1.55) for cases within 2005 depth range (38-51 mm), and 1.17 (95% CI, 0.91, 1.50) for cases within 2010 depth range (>50 mm) compared to those with an average depth of <38 mm. The adjusted odds ratio of survival was 1.33 (95% CI, 1.01, 1.75) for cases within 2015 depth range (50 to 60 mm) for at least 60% of minutes.
CONCLUSIONS
This analysis of patients with OHCA demonstrated that increased chest compression depth measured by accelerometer is associated with better survival. It confirms that current evidence-based recommendations to compress within 50-60 mm are likely associated with greater survival than compressing to another depth.

Identifiants

pubmed: 34331984
pii: S0300-9572(21)00264-1
doi: 10.1016/j.resuscitation.2021.07.013
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

95-104

Subventions

Organisme : NHLBI NIH HHS
ID : U01 HL077863
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077873
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077881
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077871
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077872
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077866
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077908
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077867
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077885
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077887
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077865
Pays : United States
Organisme : CIHR
Pays : Canada

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2021. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Graham Nichol (G)

University of Washington-Harborview Center for Prehospital Emergency Care, Departments of Medicine and Emergency Medicine, University of Washington, Seattle, WA, United States. Electronic address: nichol@uw.edu.

Mohamud R Daya (MR)

Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, United States.

Laurie J Morrison (LJ)

Department of Emergency Medicine, St Michael's Hospital, Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Tom P Aufderheide (TP)

Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, United States.

Christian Vaillancourt (C)

Ottawa Hospital Research Institute and Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.

Gary M Vilke (GM)

Department of Emergency Medicine, University of California, San Diego, CA, United States.

Ahamed Idris (A)

Department of Emergency Medicine, University of Texas Southwestern, Dallas, TX, United States.

Siobhan Brown (S)

Department of Biostatistics, University of Washington, Seattle, WA, United States.

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Classifications MeSH