Letter by Ristagno and Gullo Regarding Article, “Survival Is Similar After Standard Treatment and Chest Compression Only in Out-of-Hospital Bystander Cardiopulmonary Resuscitation”

Abstract

To the Editor: We appreciated the elegant study by Bohm et al,1 which has reported equivalency of survival among victims of cardiac arrest who received standard cardiopulmonary resuscitation (CPR) and those who received chest compressions–only (CCo) CPR. According to this study, smaller ventilations are required to maintain optimal ventilation/perfusion ratios during CPR, and in animal models, adverse outcomes followed prolonged interruptions in chest compressions for mouth-to-mouth ventilation.2 During lung inflation, venous return is transiently reduced, with the result that preload and ultimately aortic diastolic pressure is decreased. Systemic blood flow and organ perfusions are correspondingly reduced. The highest priority after “sudden death” is to start …