Chest Compression Fraction and Factors influencing it

Deo Mathew; S Vimal Krishnan; Siju V Abraham; Salish Varghese; Minu Rose Thomas; Babu Urumese Palatty

doi:10.4103/JETS.JETS_36_21

Chest Compression Fraction and Factors influencing it

J Emerg Trauma Shock. 2022 Jan-Mar;15(1):41-46. doi: 10.4103/JETS.JETS_36_21. Epub 2021 Nov 23.

Authors

Deo Mathew¹, S Vimal Krishnan², Siju V Abraham¹, Salish Varghese¹, Minu Rose Thomas³, Babu Urumese Palatty¹

Affiliations

¹ Department of Emergency Medicine, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.
² Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India.
³ Department of Anaesthesia, Amala Medical College, Thrissur, Kerala, India.

Abstract

Introduction: Chest compression fraction (CCF) is the cumulative time spent providing chest compressions divided by the total time taken for the entire resuscitation. Targeting a CCF of at least 60% is intended to limit interruptions in compressions and maximize coronary perfusion during resuscitation. We aimed to identify the mean CCF and its relationship with various factors affecting it.

Methods: Patients presenting to the emergency department in cardiac arrest at a single center were prospectively included in this study. Resuscitation was provided by trained health-care providers. The feedback device Cprmeter2™ was placed on the patient's sternum at the beginning of resuscitation. The total time taken for the entire resuscitation was noted by the device and CCF calculated.

Results: The mean CCF was analyzed using descriptive statistics and was found to be 71.60% ± 7.52%. The total duration of resuscitation (R = -0.55, P = < 0.001, min-max, 2.02-34.31, mean 12.25 ± 6.54), number of people giving chest compressions (R = -0.48, P = < 0.001, min-max, 1-6, mean 4.04 ± 1.12), and total number of team members in resuscitation (R = -0.50, P = < 0.001, min-max, 4-10, mean 6.65 ± 1.32) had negative correlation with CCF. Diurnal variation (day, n = 35; mean 69.20% ± 7% and night, n = 20; mean 75.80% ± 5.6%, P = 0.001) and patients receiving defibrillation (receiving n = 10 mean 67.00% ± 4.11% and not receiving n = 45 mean 72.62 ± 7.42%, P = 0.005) were found to significantly affect CCF.

Conclusion: The mean CCF for cardiac arrest patients was well within the targets of guideline recommendation. CCF decreased when resuscitation lasted longer, during daytime when the defibrillator was used, the total team members increased, and also when the number of people giving chest compressions increased. CCF during resuscitation may improve if there is a focus on improving these factors and requires validation in multicentric settings.

Keywords: Cardiac arrest; cardiopulmonary resuscitation; chest compression fraction; defibrillation; emergency department.