Featured Research

from universities, journals, and other organizations

New Resuscitation Approach For Out-of-hospital Cardiac Arrest Associated With Increased Survival, Study Shows

Date:
March 11, 2008
Source:
JAMA and Archives Journals
Summary:
Patients who had cardiac arrests outside of the hospital setting and were treated with a resuscitation approach designed to limit interruption of chest compressions, termed minimally interrupted cardiac resuscitation, were more likely to survive than those patients who received standard treatments, according to a new study.

Patients who had cardiac arrests outside of the hospital setting and were treated with a resuscitation approach designed to limit interruption of chest compressions, termed minimally interrupted cardiac resuscitation (MICR), were more likely to survive than those patients who received standard treatments, according to a new study.

Related Articles


"Out-of-hospital cardiac arrest is a major public health problem and a leading cause of death," the authors write. "Although early defibrillation with automated external defibrillators improves survival, early defibrillation is rare and few patients with out-of-hospital cardiac arrest survive. In 2004, the average survival of patients with out-of-hospital cardiac arrest was 3 percent in the state of Arizona."

MICR, previously referred to as cardiocerebral resuscitation, is a new approach to out-of-hospital cardiac arrest for emergency medical services (EMS) personnel. MICR focuses on maximizing blood flow to the heart and brain through a series of coordinated interventions, and includes an initial series of 200 uninterrupted chest compressions, rhythm analysis with a single shock, 200 immediate post-shock chest compressions before pulse check or rhythm re-analysis, early administration of epinephrine (adrenaline, used to stimulate the heart), and delayed endotracheal intubation (placement of a flexible plastic tube into the trachea for the purpose of ventilating the lungs).

Bentley J. Bobrow, M.D., of Mayo Clinic, Scottsdale, Ariz., and colleagues investigated whether MICR would improve survival from out-of-hospital cardiac arrest. Patients with out-of-hospital cardiac arrests in two metropolitan cities in Arizona before and after MICR training of fire department emergency medical personnel were assessed. In a second analysis of protocol compliance, patients from the two metropolitan cities and 60 additional fire departments in Arizona who actually received MICR were compared with patients who did not receive MICR but received standard advanced life support.

Among the 886 patients with cardiac arrest in the two metropolitan cities, survival-to-hospital discharge increased from 4 of 218 patients (1.8 percent) in the before MICR training group to 36 of 668 patients (5.4 percent) in the after MICR training group. In the subgroup of 174 patients with a witnessed cardiac arrest and ventricular fibrillation (chaotic, irregular heart rhythm that results in little or no circulation but that may respond to defibrillation), survival increased from 2 of 43 patients (4.7 percent) in the before MICR training group to 23 of 131 patients (17.6 percent) in the after MICR training group.

For the protocol compliance analysis, overall survival-to-hospital discharge occurred in 69 of 1,799 patients (3.8 percent) who did not receive MICR and in 60 of 661 (9.1 percent) who received MICR. Survival with witnessed ventricular fibrillation and cardiac arrest occurred in 46 of 387 patients (11.9 percent) who did not receive MICR and in 40 of 141 patients (28.4 percent) who received MICR.

"Why should MICR be associated with improved outcomes after out-of-hospital cardiac arrest" One major contributor to the poor survival rates of patients with out-of-hospital cardiac arrest is prolonged inadequate myocardial and cerebral perfusion. During resuscitation efforts, the forward blood flow produced by chest compressions is so marginal that any interruption of chest compressions is extremely [harmful], especially for favorable neurological outcomes. Excessive interruptions of chest compressions by pre-hospital personnel are common. Therefore, MICR emphasizes uninterrupted chest compressions," the authors write.

"In this study, survival-to-hospital discharge of patients with an out-of-hospital cardiac arrest improved significantly after implementation of MICR as an alternate EMS protocol. These findings require confirmation in randomized trials."

Journal reference: JAMA. 2008;299[10]:1158-1165.

Editorial: Progress in Resuscitation

In an accompanying editorial, Mary Ann Peberdy, M.D., and Joseph P. Ornato, M.D., of Virginia Commonwealth University, Richmond, comment on the findings of Bobrow and colleagues.

"Although the concept of MICR needs further scientific evaluation, perhaps in the form of a randomized, controlled, clinical trial with precise documentation of protocol compliance, these details are likely not important factors to the numerous additional survivors who are back home with their families after the implementation of this new protocol. Progress in improving survival after cardiac arrest is most commonly made by a gradual evolution of science and its translation into clinical medicine rather than single, earth-shattering revolutions. This study ... represents confirmation that the quality of CPR, particularly the need for minimally interrupted chest compression and the lesser importance of positive pressure ventilation [receiving oxygen under pressure by a mechanical respirator], is a meaningful development in the evolution of resuscitation science."

Editorial reference: JAMA. 2008;299[10]:1188-1190.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Cite This Page:

JAMA and Archives Journals. "New Resuscitation Approach For Out-of-hospital Cardiac Arrest Associated With Increased Survival, Study Shows." ScienceDaily. ScienceDaily, 11 March 2008. <www.sciencedaily.com/releases/2008/03/080311165923.htm>.
JAMA and Archives Journals. (2008, March 11). New Resuscitation Approach For Out-of-hospital Cardiac Arrest Associated With Increased Survival, Study Shows. ScienceDaily. Retrieved November 24, 2014 from www.sciencedaily.com/releases/2008/03/080311165923.htm
JAMA and Archives Journals. "New Resuscitation Approach For Out-of-hospital Cardiac Arrest Associated With Increased Survival, Study Shows." ScienceDaily. www.sciencedaily.com/releases/2008/03/080311165923.htm (accessed November 24, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, November 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Winter Can Cause Depression — Here's How To Combat It

Winter Can Cause Depression — Here's How To Combat It

Newsy (Nov. 23, 2014) Millions of American suffer from seasonal depression every year. It can lead to adverse health effects, but there are ways to ease symptoms. Video provided by Newsy
Powered by NewsLook.com
Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

AFP (Nov. 23, 2014) The arable district of Kenema in Sierra Leone -- at the centre of the Ebola outbreak in May -- has been under quarantine for three months as the cocoa harvest comes in. Duration: 01:32 Video provided by AFP
Powered by NewsLook.com
Don't Fall For Flu Shot Myths

Don't Fall For Flu Shot Myths

Newsy (Nov. 23, 2014) Misconceptions abound when it comes to your annual flu shot. Medical experts say most people older than 6 months should get the shot. Video provided by Newsy
Powered by NewsLook.com
WFP: Ebola Risks Heightened Among Women Throughout Africa

WFP: Ebola Risks Heightened Among Women Throughout Africa

AFP (Nov. 21, 2014) Having children has always been a frightening prospect in Sierra Leone, the world's most dangerous place to give birth, but Ebola has presented an alarming new threat for expectant mothers. Duration: 00:37 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins