Dissemination of Chest Compression-Only Cardiopulmonary Resuscitation by Bystanders for Out-of-Hospital Cardiac Arrest in Students: A Nationwide Investigation in Japan.

Kosuke Kiyohara,Ken Nakata,Mamoru Ayusawa,Tetsuhisa Kitamura,Taku Iwami,Masahiko Nitta,Tomotaka Sobue,Yuri Kitamura

doi:10.3390/jcm11040928

Abstract

We aimed to investigate how the types of bystander-initiated cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) among students have changed recently. We also determined the association between two types of bystander-CPRs (i.e., chest compression-only CPR [CCCPR] and conventional CPR with rescue breathing [CCRB]) and survival after OHCA. From a nationwide registry of pediatric OHCAs occurring in school settings in Japan, the data of 253 non-traumatic OHCA patients (elementary, junior high, and high school/technical college students) receiving bystander-CPR between April 2008 and December 2017 were analyzed. Multivariable logistic regression analysis was conducted to assess the impact of different types of bystander-CPR on 30-day survival with favorable neurological outcomes. The proportion of patients receiving CCCPR increased from 25.0% during 2008–2009 to 55.3% during 2016–2017 (p for trend < 0.001). Overall, 53.2% (50/94) of patients receiving CCCPR and 46.5% (74/159) of those receiving CCRB survived for 30 days with favorable neurological outcomes. Multivariable analysis showed no significant difference in outcomes between the two groups (adjusted odds ratio: 1.23, 95% confidence interval: 0.67–2.28). In this setting, CCCPR is a common type of bystander-CPR for OHCA in students, and the effectiveness of CCCPR and CCRB on survival outcomes seems comparable.

Highlights

The occurrence of out-of-hospital cardiac arrest (OHCA) in school-aged children is a tragic event with a strong social impact [1]
All characteristics and outcomes considered in this study were similar across the types of bystander-cardiopulmonary resuscitation (CPR) performed on patients
Using data from the SPIRITS registry, the present study examined trends in the type of CPR performed by bystanders and its impact on survival outcomes among pediatric patients with non-traumatic OHCA occurring in schools during 2008–2017

Summary

Introduction

The occurrence of out-of-hospital cardiac arrest (OHCA) in school-aged children is a tragic event with a strong social impact [1]. Because CCCPR is simpler and easy to teach and implement [3,4], it has the potential to improve the rate of CPR implementation and overall survival of the patient. Both types of bystander-CPR are undoubtedly lifesaving in pediatric OHCA patients, previous studies have suggested that.

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Conclusion