CPR Research at the Sarver
Heart Center
Academic physicians at the UA Sarver Heart Center have been active in resuscitation research for nearly 30 years and have earned an international reputation for their findings and recommendations, some of which were incorporated in the previous national and international Guidelines for resuscitation.
However, Sarver Heart Center researcher became convinced that the National and International Guidelines Committees were not responsive to their finding and recommendations, so in November 2003, in cooperation with local and regional fire department they instituted new approaches for out-of-hospital cardiac arrest called Cardiocerebral Resuscitation, a new approach designed to markedly improve survival of patients with out-of-hospital cardiac arrest.
Cardiocerebral Resuscitation has three major components. The first is for the public. It involves an effort to educate the general public about the new, better, and easier way to do bystander resuscitation, that does not involve mouth-to-mouth resuscitation—just chest compressions. Not only is this approach more effective, it will certainly result in more individuals initiating bystander rescue efforts since they do not have to perform mouth-to-mouth breathing.
Sarver Heart Center researchers discovered years ago that overwhelming numbers of people will not perform bystander resuscitation (CPR) because they do not want to do mouth-to-mouth breathing. More recent research has found that stopping continuous chest compressions for any reason, including so called, “rescue breathing” is actually detrimental. They found that the time it takes to deliver the two 2005 Guidelines recommend two breaths interrupted chest compressions for an average of 16 seconds. This interruption of chest compression was found to be lethal. For during chest compressions for cardiac arrest the forward blood flow generated is so marginal that any interruption, including that for ventilation is harmful.
The guidelines changed in 2005 from recommended 2 ventilations for every 15 chest compressions to 30 chest compressions for every 2 ventilations. While this approach provided more chest compression, the research at the Sarver Heart Center has shown that chest compression only resuscitation still results in better neurological survival.
Chest compression only bystander is only the lay component of Cardiocerebral Resuscitation, an entirely new approach to out-of hospital cardiac arrest that has been shown in two separate observational studies to increase survival of witnessed cardiac arrest with a shockable rhythm on arrival of the paramedic/firefighters by over 300%.
For more information on Cardiocerebral Resuscitation see the following references.1-7
REFERENCES
1. Ewy G. A new approach for out-of-hospital CPR: a bold step forward. Resuscitation 2003;58:271-2.
2. Kern K, Valenzuela T, Clark L, et al. An alternative approach to advancing resuscitation science. Resuscitation 2005;64:261-8.
3. Ewy G. Cardiocerebral resuscitation: The new cardiopulmonary resuscitation. Circulation 2005;111:2134-42.
4. Kellum MJ, Kennedy KW, Ewy GA. Cardiocerebral resuscitation improves survival of patients with out-of-hospital cardiac arrest. Am J Med 2006;119:335-40.
5. Ewy GA. Cardiocerebral resuscitation should replace cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Curr Opin Crit Care 2006;12(3):189-92.
6. Ewy GA. Cardiopulmonary resuscitation--strengthening the links in the chain of survival. N Engl J Med 2000;342(21):1599-601.
7. Nagao K, SOS-KANTO. Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study. The Lancet 2007;369:920-6.
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