Number of breaths given during CPR may be linked to survival

April 05, 2004

DALLAS, April 6 - Researchers have identified a factor that may improve cardiac arrest survival rates according to a first-of-its-kind study of paramedic responses reported in today's rapid access issue of Circulation: Journal of the American Heart Association. Researchers found that some ambulance crews giving cardiopulmonary resuscitation (CPR) exceeded the American Heart Association's recommendation of 12 to 15 breaths per minute when treating cardiac arrest victims.

"The overall survival rate in the United States from cardiac arrest is about 5 percent," said lead author Tom P. Aufderheide, M.D., professor of emergency medicine at the Medical College of Wisconsin in Milwaukee. "Excessive ventilation may be contributing to that poor outcome."

The observational study included 13 cardiac arrest victims. Examining data from the first seven patients, the researchers found the average maximum ventilation rate was 37 breaths a minute, roughly 250 percent to 300 percent greater than the rate the American Heart Association recommends. After a CPR retraining program was instituted, the average ventilation rate for the next six patients dropped to 22 breaths per minute.

He suggested one solution might be to use a system that flashes a light every five seconds to let a rescuer know when to deliver another breath of oxygen.

During CPR, the chest is compressed, which increases pressure inside it and forces blood out of the heart and into the rest of the body. On the upstroke, the chest expands, which creates a slight vacuum inside. The body needs this vacuum for blood in the veins to return to the heart most efficiently. Without it, not as much blood returns to the heart.

"The decreased return of blood to the heart reduces the blood going out of the heart, and that may decrease the effectiveness of CPR." Aufderheide said.

"Medical directors of all systems--all professional rescuers, including EMTs, nurses, doctors, respiratory therapists and anyone else who would do CPR as part of their profession--need to get this message: Do not hyperventilate," he said. Although the small study focused on cardiac arrests in only one city, the researchers strongly believe that hyperventilation could occur nationwide.

As a result of their findings, the authors urge that all hospitals and emergency medical services assess whether hyperventilation is a problem in their units. If it is, they suggest reducing ventilation during CPR to 12 breaths a minute.
-end-
Co-authors are Gardar Sigurdsson, M.D.; Ronald G. Pirrallo, M.D., M.H.S.A.; Demetris Yannopoulos, M.D.; Scott McKnite, B.A.; Chris von Briesen, B.A., E.M.T.; Christopher W. Sparks, E.M.T.; Craig J. Conrad, R.N.; Terry A. Provo, B.A., EMT-P; and Keith G. Lurie, M.D.

CONTACT: For journal copies only,
please call: (214) 706-1396
For other information, call:
Carole Bullock: (214) 706-1279
Maggie Francis: (214) 706-1397

American Heart Association

Related Cardiac Arrest Articles from Brightsurf:

Outcomes for out-of-hospital cardiac arrest during COVID-19 pandemic
This study used a large US registry of out-of-hospital cardiac arrests to asses the association between the COVID-19 pandemic and the outcomes of out-of-hospital cardiac arrests, including in areas with low and moderate COVID-19 disease.

Cardiac arrest is common in critically ill patients with COVID-19
Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among patients aged 80 or older, finds a study published by The BMJ today.

In-hospital cardiac arrest in COVID-19
Outcomes of in-hospital cardiac arrest among patients with COVID-19 are examined in this case series.

New risk tool developed for cardiac arrest patients
Experts have developed a risk score to predict cardiac arrest patient outcomes.

Intravenous sodium nitrite ineffective for out-of-hospital cardiac arrest
Among patients who had an out-of-hospital cardiac arrest, intravenous sodium nitrite given by paramedics during resuscitation did not significantly improve their chances of being admitted to or discharged from the hospital alive, according to research presented at the American College of Cardiology's Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

Getting to the heart of epinephrine use in pediatric cardiac arrest patients
The effectiveness of epinephrine treatment during resuscitation of adult patients with cardiac arrest is generally promising, but little is known about its effects in pediatric patients.

Bystanders can help more cardiac arrest victims survive
Only 8% of Americans survive cardiac arrest outside a hospital, but that percentage could increase significantly if bystanders recognize cardiac arrest and perform simple lifesaving tasks, a UVA Health physician says in a New England Journal of Medicine article.

Opioid-related cardiac arrest patients differ from other cardiac arrests
People who suffer cardiac arrest due to an opioid overdose are younger, have fewer chronic medical conditions and may be more likely to be to receive bystander CPR, according to a review of emergency response records in Maine.

Selective coronary angiography following cardiac arrest
In the current issue of Cardiovascular Innovations and Applications volume 4, issue 2, pp.

Sudden cardiac arrest in athletes: Prevention and management
It's marathon season, and every so often a news report will focus on an athlete who has collapsed from sudden cardiac arrest.

Read More: Cardiac Arrest News and Cardiac Arrest Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.