Compression-Only CPR Improves Survival With Good Brain Function

DALLAS, Dec. 10, 2012 -- Chest compression-only CPR
performed by bystanders -- without rescue breathing -- keeps more
people alive with good brain function after having a sudden cardiac
arrest, according to a Japanese study reported in Circulation: Journal
of the American Heart Association.

Compression-only CPR from bystanders should start immediately after the
cardiac arrest, followed by a shock with an automated external
defibrillator, or AED, said Taku Iwami, MD, PhD, study lead author
and senior lecturer in the Department of Preventive Services at Kyoto
University School of Public Health in Japan.

"Early initiation of CPR and shocks from a public access AED are the
keys to saving lives from sudden cardiac arrest," he said.

Researchers analyzed the records of 1,376 people in Japan who had
sudden cardiac arrests between 2005 and 2009 that were witnessed and
received CPR and AED shocks from bystanders. Of these arrests, 36.8
percent received compression-only CPR and 63.2 percent received
conventional CPR with chest compressions and breaths.

When comparing survivors after one month, researchers found:

-- More than 46 percent (46.4) of the compression-only CPR patients were
alive, compared to 39.9 percent of those who received conventional CPR.

-- The chest-compression-only CPR led to 40.7 percent of patients having
favorable brain function compared to 32.9 percent of those who received
traditional CPR. Patients were considered to have favorable neurological
status if they had normal brain function or if they lived independently
-- even if they had some neurological impairment.

In addition to the improved outcomes, performing CPR with chest
compressions only is also preferable because it's easier to learn and
preferred by those uncomfortable with mouth-to-mouth rescue breathing,
Iwami said.

"Rescue breathing is difficult for some people to perform and might
interrupt chest compressions," he said.

The study results also apply to people in the United States and other
countries, Iwami said. "Most victims don't receive any CPR, so we need
to encourage chest-compression-only CPR and public access
defibrillation programs."

The study reports that the combination of early defibrillation with
public-access AEDs and compression-only CPR provided by bystanders in
witnessed cardiac arrest can provide neurologically favorable survival
rates of over 40 percent.

"Across the United States, too many people are dying from sudden
cardiac arrest because family members and friends of the victim are
unsure how to help. This study confirms that Hands-Only CPR is highly
effective. Plus it's easy to do," said Michael Sayre, M.D., national
spokesperson for the American Heart Association and Professor of
Emergency Medicine at the University of Washington.

The American Heart Association recommends that bystanders do Hands-Only
CPR -- pushing hard and fast in the center of a victim's chest -- if
they see an adult suddenly collapse.

Iwami said further studies are needed on whether bystanders should
perform compression-only CPR on children.

For infants (up to age one) and children (up to puberty), the
association recommends CPR with a combination of breaths and
compressions.