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Chest compressions interrupted for rescue breathing saves more lives

Although the difference was slight, 1 percent of patients fared better after getting CPR with ventilation -- a significant amount when considering life and death.

By Stephen Feller
Chest compressions interrupted for rescue breathing saves more lives
Bystanders are recommended to provide CPR with only chest compressions, researchers said, as the study was focused on EMS treatment at the scene and on the way to the hospital. Photo by David Molina G/Shutterstock

BETHESDA, Md., Nov. 10 (UPI) -- Although the difference was not large, a new study found patients given cardiopulmonary resuscitation with pauses for ventilation during chest compressions survived to be discharged from the hospital more often and had better outcomes during the next 30 days than patients who were given CPR without the pauses.

Researchers think pausing compressions for ventilation is beneficial because it causes improved blood flow and oxygenation. Although standard CPR calls for ventilation, providing CPR with or without rescue breathing is acceptable.

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The study focused on emergency staff providing CPR at the scene or on the way to the hospital -- either with ventilation provided by a bag valve mask or not -- not bystanders responding to a sudden situation. Bystanders generally perform continuous chest compressions until paramedics arrive to provide treatment.

"Current CPR guidelines permit use of either continuous chest compressions or interrupted chest compressions with ventilations by EMS providers," Dr. Graham Nichol, director of the University of Washington-Harborview Center for Prehospital Emergency Care, said in a press release. "Our trial shows that both types of CPR achieve good outcomes, but that compressions with pauses for ventilations appears to be a bit better."

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Researchers compared survival rates for 23,709 adults who had cardiac arrest and were treated by 114 emergency agencies between June 2011 and May 2015. About half the patients received continuous compressions and the rest received compressions with pauses for ventilation.

The data showed 8.9 percent of patients who received continuous compressions survived to be discharged from the hospital, compared to 9.7 percent receiving CPR with ventilation. Patients receiving ventilation also had more days alive outside the hospital in the month after a heart attack.

Additionally, the researchers found 7.7 percent of patients who received ventilation had favorable neurological function scores on the Rankin scale, as opposed to 7 percent of the group not receiving ventilation.

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Although differences between the groups of patients were not large, researchers said the slight difference is significant in terms of life and may lead to changes in guidelines for CPR depending on the situation at hand.

"This is the first randomized trial to show a significant difference in outcomes after hospital admission among patients treated for out-of-hospital cardiac arrest," Nichol said in a press release. "We can improve outcomes for this common health condition. We believe that this study is a significant step in that direction."

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The study is published in the New England Journal of Medicine.

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