Comparison of Continuous Versus Interrupted Chest Compressions during CPR in a Rural Community

Abstract

Cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiac arrest (OHCA) have interruption of manual chest compressions for airway management and breathing when performed by medical personnel trained by Advanced Cardiac Life Support (ACLS) standards. This interruption likely reduces blood flow and possibly survival. Traditional CPR (30:2 compressions to ventilations) was compared with continuous chest compressions, CCC (also termed Cardiocerebral Resuscitation, CCR) in a rural community. A retrospective cohort analysis of three years of traditional CPR (June 2008 - May 2011) for OHCA was compared to three years of using CCC protocols (June 2011 - May 2014). Primary outcomes were survival at one and six months. There were 58 0HCA patients in the six year study period (June 2008 - May 2014). Forty (69%) received CPR and 18 (31%) received CCC. Two (5%) survived at least one month with CPR and eight (44%) survived at least one month with CCC (p = 0.0007). After six months, 0/40 (0%) who received CPR had survived and 6/18 (33%) who received CCC survived (p = 0.0018). For the patient found in ventricular fibrillation or tachycardia (a shockable rhythm), 0/13 (0.0%) survived one month after CPR and 7/9 (78%) survived with CCC (p < 0.01). After six months 0/13 (0.0%) survived with CPR and 6/9 (67%) survived with CCC (p < 0.05). For patients in a rural environment with OHCA, CCC had a more favorable outcome than traditional CPR. For the patient found in ventricular fibrillation or ventricular tachycardia, there was a profound survival benefit of CCC over CPR.