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A randomized trial of compression first or analyze first strategies in patients with out-of-hospital cardiac arrest: results from an Asian community.

Abstract：

BACKGROUND:It is still under debate whether a period of cardiopulmonary resuscitation should be performed prior to rhythm analysis for defibrillation for out of hospital cardiac arrests (OHCA). This study compared outcomes of OHCA treated by "compression first" (CF) versus "analyze first" (AF) strategies in an Asian community with low rates of shockable rhythms. METHODS:This randomized trial was conducted in Taipei City between February 2008 and December 2009. Dispatches of suspected OHCA that activated advanced life support teams were randomized into the CF and AF strategies. Patients assigned to CF strategy received 10 cycles of CPR prior to analysis by automatic external defibrillator. The primary outcome was sustained (>2 h) return of spontaneous circulation (ROSC) and secondary outcome was survival to hospital discharge. RESULTS:We included 289 cases in the final analysis after exclusion by pre-specified criteria, 141 were allocated to CF strategy and 148 to AF strategy. Baseline characteristics were similar. Thirty-seven (26.2%) of those receiving CF strategy and 49 (33.1%) of the AF strategy achieved sustained ROSC (p=0.25). In a post-hoc analysis of patients who achieved ROSC, those that received CF strategy were more likely to be discharged alive from the hospital (16/37=43.2% vs. 11/49=22.4%, p=0.02). CONCLUSION:In this study population of low rates of shockable rhythms, there was no difference in ROSC for CF or AF strategies. Considering the EMS operation situations, a period of paramedic-administered CPR for up to 10 cycles prior to rhythm analysis could be a feasible strategy in this community.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Ma MH,Chiang WC,Ko PC,Yang CW,Wang HC,Chen SY,Chang WT,Huang CH,Chou HC,Lai MS,Chien KL,Lee BC,Hwang CH,Wang YC,Hsiung GH,Hsiao YW,Chang AM,Chen WJ,Chen SC

doi

10.1016/j.resuscitation.2012.01.009

subject

Has Abstract

pub_date

2012-07-01 00:00:00

pages

806-12

issue

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(12)00024-X

journal_volume

pub_type

杂志文章,随机对照试验

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A randomized trial of compression first or analyze first strategies in patients with out-of-hospital cardiac arrest: results from an Asian community.