Prolonged resuscitation increases the chance of survival

The longer the resuscitation attempts, the higher the chance of survival

06.09.2012

Prolongation of resuscitation efforts can significantly increase the patient's chance of survival. This is the conclusion of a study by US scientists led by Zachary Goldberger of the Department of Cardiovascular Medicine at the University of Michigan. Correspondingly, the resuscitation attempts in the clinics should be carried out much longer than usual, according to the conclusion of the US researchers.

"Although we can not define an optimal duration for resuscitation attempts, our findings suggest that efforts to systematically increase the resuscitation duration improve the chance of survival," Goldberger and colleagues in the journal "The Lancet" report. According to the results of the US researchers, the probability of survival is 25% higher for a 25-minute resuscitation period than for resuscitation attempts, which are already set after 16 minutes. Patients' chances of survival tend to increase as cardiopulmonary resuscitation lasts longer, the US researchers write.

Data from nearly 65,000 cardiac arrest patients analyzed
In the current study, US scientists evaluated data from 64,339 patients treated for cardiac arrest in one of 435 US hospitals. Although the guidelines for cardiopulmonary resuscitation are very precise, there are as yet no clear recommendations as to the required duration of resuscitation, the experts explained. Researchers calculated the average duration of resuscitation for each hospital, both in deaths and survivors. The average resuscitation duration for the surviving cardiac arrest patients was therefore about twelve minutes, while for the deaths the resuscitation attempts were stopped on average after 20 minutes. The respective resuscitation time was extremely different in the clinics. In order to assess the relationship between the duration of resuscitation and the patient's chance of survival, researchers compared the quarter of the clinics with the lowest average resuscitation time (16 minutes) to the quarter of hospitals where the longest on average (25 minutes ) was resuscitated.

Longer resuscitation increases the chance of survival by twelve percent
According to the US scientists, the result of the comparison shows that patients with an average resuscitation time of 16 minutes had a 12-percent chance of surviving patients compared to hospitals with an average resuscitation period of 25 minutes. Thus, the study contradicts the findings of previous studies, which found that prolonged resuscitation attempts hardly influence the survival probability of cardiac arrest patients. However, Goldberger and colleagues concluded in the article "Duration of CPR and Cardiac Survival Survival" that a 10 or 15 minute resuscitation could significantly improve the patient's chances of survival. Negative effects such as brain damage due to lack of oxygen during longer attempts at resuscitation have not been observed by the researchers in their study.

New cardiopulmonary resuscitation policy required
According to US scientists, about 20 percent of patients hospitalized for cardiac arrest survive today. This number could possibly be significantly increased if new guidelines for cardiopulmonary resuscitation were issued in the future, which take into account a systematic prolongation of the resuscitation period. Also for first aiders adapted guidelines should be developed. In case of doubt, anyway: Reanimate rather longer, instead of giving up hope early. (Fp)

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