Compression depth measured by accelerometer vs. outcome in patients with out-of-hospital cardiac arrest.
CPR
Cardiac arrest
Compression depth
Outcome
Journal
Resuscitation
ISSN: 1873-1570
Titre abrégé: Resuscitation
Pays: Ireland
ID NLM: 0332173
Informations de publication
Date de publication:
10 2021
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
95-104Subventions
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.