283 CPR Duration and Survival in Out-of-Hospital Cardiac Arrest Patients

Abstract

Relation between cardiopulmonary resuscitation duration and long-term survival after out-of-hospital cardiac arrest (OHCA) remains unclear. In the current study, our primary aim was to determine the association between long-term survival without neurologic sequelae and values of no-flow (NF) and low-flow (LF) in the setting of witnessed OHCA of medical (non-traumatic) origin. We analyzed 27,301 non-traumatic out-of-hospital witnessed cardiac arrest patients in France included in the French National Registry of Cardiac Arrest (ReAC registry) from June 1, 2015 through December 1, 2015. We analyzed characteristic times of CPR divided as no-flow and low-flow in relation with survival without sequelae at 28 days. We have determined the influence of recognized prognosis characteristics (age, sex, initial rhythm, location of cardiac arrest) on this relation. For the entire cohort, the area delimitated by the value of NF interval more than 12 minutes and LF interval more than 33 minutes, the probability of 28-day survival without neurologic sequelae was less than 1% (Figure 1). These sets of values were greatly (p<0.001) influenced by initial rhythm of cardiac arrest, age, sex and location of cardiac arrest (Figure 2). Long CPR duration (more than 40 minutes) in case of initial shockable cardiac rhythm is associated with survival more than 1% with NF less than 18 minutes. NF interval is highly influential on LF interval (p<0.0001). NF duration must be considered in order to determine the CPR duration in out-of-hospital cardiac arrest patients. The knowledge of (NF, LF) curves as function of age, initial rhythm, location of cardiac arrest or sex may help the physician to decide the withdrawal the CPR or to envisage alternative technique.View Large Image Figure ViewerDownload Hi-res image Download (PPT)