Effects of Chest Compression Fraction on Return of Spontaneous Circulation in Patients with Cardiac Arrest; a Brief Report

Ashok Kumar Uppiretla; Gangalal G M; Suhas Rao; Donnel Don Bosco; Shareef S M; Vivek Sampath

doi:10.22114/ajem.v0i0.147

Effects of Chest Compression Fraction on Return of Spontaneous Circulation in Patients with Cardiac Arrest; a Brief Report

Adv J Emerg Med. 2019 Jun 6;4(1):e8. doi: 10.22114/ajem.v0i0.147. eCollection 2020 Winter.

Authors

Ashok Kumar Uppiretla¹, Gangalal G M¹, Suhas Rao¹, Donnel Don Bosco¹, Shareef S M¹, Vivek Sampath¹

Affiliation

¹ Department of Emergency Medicine, Kerala Institute of Medical Sciences, Trivandrum, India.

Abstract

Introduction: The association between chest compression fraction (CCF) and return of spontaneous circulation (ROSC)has been a controversial issue in literature; and both positive and negative correlations have been reported between CCF and survival rate.

Objective: The present study was conducted to determine the relationship between the rate and outcomes of chest compression and between CCF and ROSC in patients with cardiac arrest.

Method: The present prospective observational study was conducted during 2018 on patients with cardiac arrest aged 18-80 years. Participants with end-stage renal diseases, malignancies and grade IV heart failure were excluded. A stop watch was set upon the occurrence of a code blue in the emergency department, and time was recorded by the observer upon the arrival of the code blue team leader (a maximum permissible duration of 10 minutes). The interruptions in chest compressions were recorded using a stopwatch, and CCF was calculated by dividing the duration of chest compression by the total duration of cardiac arrest observed.

Results: Totally, 45 participants were enrolled. Most of the patients had non-shockable rhythms and underwent CPR based on related algorithm. Hypoxia and hypovolemia were the two probable etiology of cardiac arrest; and coronary artery disease was the most prevalent underlying disease. All patients with ROSC had CCF more than 70%. A CCF below 70% was observed in 21 cases (46.7%), and a fraction of at least 70% in 24 cases. All patients with ROSC had CCF more than 70%. A CCF below 70% was observed in 21 cases (46.7%), and a fraction of at least 70% in 24. A significantly higher duration and fraction of chest compression was observed in the participants who attained ROSC (P<0.001).

Conclusion: Based on the findings of current study, it seems that significantly higher chest compression durations and fractions were found to be associated with ROSC, which was achieved in the majority of the participants with a CCF of at least 80%.

Keywords: Cardiopulmonary Resuscitation; Heart Massage; Outcome; Quality Indicators, Health Care.