Rendering CPR for 30 minutes—Is it worth it?

Experts agree that the sooner CPR is started on an individual whose heart stopped, the greater the chances of survival. Japanese researchers have reported that continuing CPR half an hour or longer may help patients survive with good brain function. The study specifically determined that 38 minutes of CPR may recover and have good brain function.

The findings of this study will be presented at the annual American Heart Association meeting in Dallas. Despite the findings that giving CPR for longer periods may be worth it, some are still skeptical on the findings.

AHA-New-CPR-Guidelines

According to Dr. Hector Medina, a cardiologist at Scott and White Healthcare in Round Rock, Texas, “… [this] study has to be looked at with a lot of caution. Thirty-eight minutes is long time, even for a young patient.” He continued by saying that, “In routine practice, after 30 minutes… we give really good thought about the feasibility of continuing the resuscitation effort, particularly in older patients.”

Dr. Medina said that since the study has to be reported at a meeting and has not being published in a peer-reviewed journal, it is difficult to draw conclusions.

Study Findings

The researchers reviewed data on more than 280,000 individuals who had experienced a cardiac arrest outside a hospital. In each episode of the cardiac arrest, there was a person nearby.  The study was narrowed down to a group of individuals whose heart started beating after resuscitation. This is called “return of spontaneous circulation.” This group had almost 32,000 people.

Researchers found that after 30 days of the cardiac arrest, more than 27% had good brain function. Those that averaged 13 minutes from the moment their heart stopped until it started beating again had good brain function.  The less favorable outcomes occurred when CPR averaged 22 minutes. Some people had favorable outcomes after 38 minutes of resuscitation.  The most important piece of information showed that with each minutes that passed, the odds of surviving without severe brain damage dropped by 5%.

Dr. Suzanne Steinbaum, a preventative cardiologist at Lenox Hill Hospital in New York City, analyzed the findings of the study. According to Dr. Steinbaum, the return to spontaneous circulation by 13 minutes offered the best neurological outcomes and anything beyond 38 minutes did not have favorable outcomes. Both of the experts said that it wouldn’t be possible for one person to do 38 minutes of resuscitation on their own. In a hospital, Dr. Medina stated that health care workers trade off every 3 minutes or so because CPR is a very labor intense activity.

The American Heart Association has recently simplified CPR recommendations and recommended only hands-on resuscitation. Hands-on CPR guidelines advice called 911 and then pushing hard and fast on the center of the chest. According to AHA, doing hands-on CPR can double a person’s chance of survival. Other research presented at the meeting stated when people at a shopping mall were shown a one-minute video detailing hands-on CPR, they were more likely to call 911 and initiate hands-only CPR. Dr. Steinbaum states that people should not feel like there is nothing to do in these circumstances, she recommends calling 911 and starting compressions.

Resource:

http://www.philly.com/philly/health/HealthDay682140_20131118_Giving_CPR_for_More_Than_30_Minutes_May_Be_Worth_It.html

Valley Occupational Medical Center

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