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Outcome of Conventional Bystander Cardiopulmonary Resuscitation in Cardiac Arrest Following Drowning

Published online by Cambridge University Press:  24 January 2020

Joshua M. Tobin*
Affiliation:
Keck School of Medicine of the University of Southern California, Division of Trauma Anesthesiology, Los Angeles, California USA
William D. Ramos
Affiliation:
Indiana University School of Public Health-Bloomington, Bloomington, Indiana USA
Joel Greenshields
Affiliation:
Indiana University School of Public Health-Bloomington, Bloomington, Indiana USA
Stephanie Dickinson
Affiliation:
Indiana University School of Public Health-Bloomington, Bloomington, Indiana USA
Joseph W. Rossano
Affiliation:
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA
Peter G. Wernicki
Affiliation:
Florida State University, College of Medicine, Tallahassee, Florida USA
David Markenson
Affiliation:
New York Medical College, Center for Disaster Medicine, Valhalla, New York USA
Kimberly Vellano
Affiliation:
CARES Program, Emory University, Woodruff Health Sciences Center, Atlanta, Georgia USA
Bryan McNally
Affiliation:
CARES Program, Emory University, Woodruff Health Sciences Center, Atlanta, Georgia USA
*
Correspondence: Joshua M. Tobin, MD Keck School of Medicine University of Southern California Division of Trauma Anesthesiology 2051 Marengo Street, IPT C4E100 Los Angeles, California 90033 USA E-mail: [email protected]

Abstract

Introduction:

The concept of compressions only cardiopulmonary resuscitation (CO-CPR) evolved from a perception that lay rescuers may be less likely to perform mouth-to-mouth ventilations during an emergency. This study hopes to describe the efficacy of bystander compressions and ventilations cardiopulmonary resuscitation (CV-CPR) in cardiac arrest following drowning.

Hypothesis/Problem:

The aim of this investigation is to test the hypothesis that bystander cardiopulmonary resuscitation (CPR) utilizing compressions and ventilations results in improved survival for cases of cardiac arrest following drowning compared to CPR involving compressions only.

Methods:

The Cardiac Arrest Registry for Enhanced Survival (CARES) was queried for patients who suffered cardiac arrest following drowning from January 1, 2013 through December 31, 2017, and in whom data were available on type of bystander CPR delivered (ie, CV-CPR CO-CPR). The primary outcome of interest was neurologically favorable survival, as defined by cerebral performance category (CPC).

Results:

Neurologically favorable survival was statistically significantly associated with CV-CPR in pediatric patients aged five to 15 years (aOR = 2.68; 95% CI, 1.10–6.77; P = .03), as well as all age group survival to hospital discharge (aOR = 1.54; 95% CI, 1.01–2.36; P = .046). There was a trend with CV-CPR toward neurologically favorable survival in all age groups (aOR = 1.35; 95% CI, 0.86–2.10; P = .19) and all age group survival to hospital admission (aOR = 1.29; 95% CI, 0.91–1.84; P = .157).

Conclusion:

In cases of cardiac arrest following drowning, bystander CV-CPR was statistically significantly associated with neurologically favorable survival in children aged five to 15 years and survival to hospital discharge.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2020

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References

Svensson, L, Bohm, K, Castren, M, et al. Compression-only CPR or standard CPR in out-of-hospital cardiac arrest. N Engl J Med. 2010;363(5):434442.CrossRefGoogle ScholarPubMed
Cabrini, L, Biondi-Zoccai, G, Landoni, G, et al. Bystander-initiated chest compression-only CPR is better than standard CPR in out-of-hospital cardiac arrest. HSR Proc Intensive Care Cardiovasc Anesth. 2010;2(4):279285.Google ScholarPubMed
Hupfl, M, Selig, HF, Nagele, P. Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis. Lancet. 2010;376(9752):15521557.CrossRefGoogle ScholarPubMed
Sayre, MR, Berg, RA, Cave, DM, et al. Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. Circulation. 2008;117(16):21622167.CrossRefGoogle Scholar
Edwards, ND, Timmins, AC, Randalls, B, Morgan, GA, Simcock, AD. Survival in adults after cardiac arrest due to drowning. Intensive Care Med. 1990;16(5):336337.CrossRefGoogle ScholarPubMed
Rudolph, SS, Barnung, S. Survival after drowning with cardiac arrest and mild hypothermia. ISRN Cardiol. 2011;2011:895625.CrossRefGoogle ScholarPubMed
Kieboom, JK, Verkade, HJ, Burgerhof, JG, et al. Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia: Dutch nationwide retrospective cohort study. BMJ. 2015;350:h418.CrossRefGoogle ScholarPubMed
Berg, RA, Hilwig, RW, Kern, KB, Ewy, GA.Bystander” chest compressions and assisted ventilation independently improve outcome from piglet asphyxial pulseless “cardiac arrest.Circulation. 2000;101(14):17431748.10.1161/01.CIR.101.14.1743CrossRefGoogle ScholarPubMed
Kitamura, T, Iwami, T, Kawamura, T, et al. Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study. Lancet. 2010;375(9723):13471354.CrossRefGoogle ScholarPubMed
Naim, MY, Burke, RV, McNally, BF, et al. Association of bystander cardiopulmonary resuscitation with overall and neurologically favorable survival after pediatric out-of-hospital cardiac arrest in the United States: a report from the Cardiac Arrest Registry to Enhance Survival surveillance registry. JAMA Pediatr. 2017;171(2):133141.CrossRefGoogle ScholarPubMed
Ogawa, T, Akahane, M, Koike, S, Tanabe, S, Mizoguchi, T, Imamura, T. Outcomes of chest compression only CPR versus conventional CPR conducted by lay people in patients with out of hospital cardiopulmonary arrest witnessed by bystanders: nationwide population based observational study. BMJ. 2011;342:c7106.CrossRefGoogle ScholarPubMed
Claesson, A, Lindqvist, J, Herlitz, J. Cardiac arrest due to drowning--changes over time and factors of importance for survival. Resuscitation. 2014;85(5):644648.CrossRefGoogle ScholarPubMed
Tobin, JM, Ramos, WD, Pu, Y, Wernicki, PG, Quan, L, Rossano, JW. Bystander CPR is associated with improved neurologically favorable survival in cardiac arrest following drowning. Resuscitation. 2017;115:3943.10.1016/j.resuscitation.2017.04.004CrossRefGoogle Scholar