This is starting to pull together some
real data which has been missing. These
appear to be the results from present practice or perhaps even the lack
thereof. My own experience of a collapse
with immediate quality CPR for twenty minutes before a pulse shows us that the
potential threshold is much higher. Yet
average CPR is enough to get the victim through the first ten minutes. This is enough to allow help to arrive and
take over.
Other reports have taken the threshold
into the two and one half hour mark.
Thus CPR is now saving lives of heart attack victims and those victims
are no longer been abandoned prematurely.
This means that the statistics of less than ten percent will begin to
change strongly for the better.
It is sobering to know that I dodged
that statistic and just happened to have help available at the VGH emergency
ward a mere five blocks away and had a trained male nurse with robust arms in the
room with me to apply emergency CPR.
That was in 2005. That particular
demonstration woke folks up and following examples clearly made the case. I suspect that the AHA guidelines changed
in 2010 to reflect that new reality. My
example may not have mattered, but few could be clearer.
16-Nov-2013
Carrie Thacker
carrie.thacker@heart.org
214-706-1665
214-706-1665
Performing CPR for 38 minutes or longer can
improve a patient's chance of surviving cardiac arrest, according to a study
presented at the American Heart Association's Scientific Sessions 2013.
Sustaining CPR that long also improves the
chances that survivors will have normal brain function, researchers said.
Cardiac arrest occurs when electrical impulses in the heart become rapid or
chaotic, causing it to suddenly stop beating.
About 80 percent of cardiac arrests — nearly
288,000 people — occur outside of a hospital each year, and fewer than 10
percent survive, according to the American Heart Association.
Research has found that early return of
spontaneous circulation — the body pumping blood on its own — is important for
people to survive cardiac arrest with normal brain function. But little
research has focused on the period between cardiac arrest and any return of
spontaneous circulation.
Using a massive registry tracking all
out-of-hospital cardiac arrests in Japan in 2005-11, researchers studied how
much time passed between survivors' collapse and the return of spontaneous
circulation, and how well brain function was preserved a month later.
Survivors were considered to have fared well
neurologically if they were alert and able to return to normal activities, or
if they had moderate disability but were well enough to work part-time in a
sheltered environment or take part in daily activities independently.
The time between collapse and return of
spontaneous circulation for those who fared well was 13 minutes compared to
about 21 minutes for those who suffered severe brain disability, said Ken
Nagao, M.D., Ph.D., professor and director-in-chief of the Department of
Cardiology, CPR and Emergency Cardiovascular Care at Surugadai Nihon University
Hospital in Tokyo.
After adjusting for other factors that can
affect neurological outcomes, researchers found that the odds of surviving an
out-of-hospital cardiac arrest without severe brain damage dropped 5 percent
for every 60 seconds that passed before spontaneous circulation was restored.
Based on the relationship between favorable
brain outcomes and the time from collapse to a return of spontaneous
circulation, the researchers calculated
that CPR lasting 38 minutes or more was advisable.
"It may be appropriate to continue CPR if
the return of spontaneous circulation occurs for any period of time," said
Nagao. The 2010 AHA Guidelines for CPR and ECC advise bystanders to perform
CPR until emergency crews arrive.
###
The Japanese Circulation Society Resuscitation
Science Study group conducted the study.
Co-authors are Eizo Tachibana, M.D., Ph.D.;
Tukasa Yagi, M.D., Ph.D; Naohiro Yonemoto, Dr.P.H.; Morimasa Takayama, M.D.,
Ph.D.; Hiroshi Nogoni, M.D., Ph.D.; Shinichi Shirai, M.D., Ph.D.; and Takeshi
Kimura, M.D., Ph.D. Author disclosures are on the abstract.
For more information, see CPR facts and
statistics.
For more news from AHA Scientific Sessions 2013
follow us on Twitter @HeartNews #AHA13.
Statements and conclusions of study authors that
are presented at American Heart Association scientific meetings are solely
those of the study authors and do not necessarily reflect association policy or
position. The association makes no representation or warranty as to their
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Note: Actual
presentation is 5:15 p.m. CT/6:15 pm ET Saturday, Nov. 16, 2013.
Downloadable video/audio interviews, B-roll,
animation and images related to this news release are on the right column of
the release link at http://newsroom.heart.org/news/cpr-for-38-minutes-or-longer-improves-chance-to-survive-cardiac-arrest
Video clips with researchers/authors of the
studies will be added to the release link after embargo.
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