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Feb 01 2013

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Longer CPR Saves Lives in Children and Adults

CPR

The conventional thinking has been that CPR is futile after 20 minutes, but these results challenge that, said Dr. Berg.

Two recently published studies show that extending cardiopulmonary resuscitation (CPR) longer than previously thought useful saves lives in children and adults. The research teams analyzed the impact of duration of CPR in patients who suffered cardiac arrest while hospitalized.

“These findings about the duration of CPR are game-changing, and we hope these results will rapidly affect hospital practice,” said Robert A. Berg, MD, chief of Critical Care Medicine at Children’s Hospital. Dr. Berg is also chair of the Scientific Advisory Board of the American Heart Association’s Get With Guidelines-Resuscitation program (GWTG-R), a national registry that tracks and analyzes the resuscitation of patients after in-hospital cardiac arrests.

The investigators reported data from the GWTG-Resuscitation registry of CPR outcomes in thousands of North American hospital patients in two landmark studies, one of which was focused on children.

In the pediatric study, to which Dr. Berg contributed as a co-author, the researchers analyzed the hospital records of 3,419 children in the U.S. and Canada from 2000 through 2009. They found that among children who suffered in-hospital cardiac arrest, more children than expected survived after prolonged CPR. Of those children who survived prolonged CPR — which is defined as lasting longer than 35 minutes — over 60 percent had good neurologic outcomes.

The pediatric results parallel those found in the second GWTG-R investigation, which examined 64,000 adult patients with in-hospital cardiac arrests between 2000 and 2008. Dr. Berg also was also a co-author of that study.

The conventional thinking has been that CPR is futile after 20 minutes, but these results challenge that, said Dr. Berg.

“Taken together, the adult and pediatric results present a clear and hopeful message: persisting longer with CPR can offer better results than previously believed possible,” concluded Dr. Berg.

To read more about the CPR studies, see the full press release.

Permanent link to this article: http://www.research.chop.edu/blog/longer-cpr-saves-lives-in-children-and-adults/

2 comments

  1. Jayden Miles

    I have just been through medical training where they also taught us CPR. On hearing the stories from instructor, sometimes the mid bone might break when performing CPR especially those with chest injuries sustained from car crash or accidents and this could cause further injuries with broken bone splinters while performing CPR. But generally I would have to agree to the context that longer CPR performed would yield a better surviving chance.

  2. Keijo Musto

    I read the above report with interest.
    Good work!

    Here is another thought.

    Would not the effectiveness of CPR be improved if the small amount of
    blood flow generated by the CPR could be selectively directed to the
    brain and major organs.

    A fast and easy way to accomplish this during CPR would be the
    simultaneous application of inflatable cuffs to the arms and legs.
    This would reduce the blood flow to the brachial and femoral arteries and
    conversely increase the flow to the major organs and in particular to the carotid arteries, thereby possibly
    further improving outcomes.

    Has this been trialled and if not, would it be worth trialling?

    Keijo Musto

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