Cardio-pulmonary resuscitation (CPR) for out-of-hospital cardiac arrest should be conducted for at least 35 minutes, according to a new study.
The study in more than 17 000 patients found that nearly all survivals were achieved within 35 minutes and longer CPR achieved little benefit.
Yoshikazu Goto said that the decision regarding when to stop resuscitation efforts is one of the biggest challenges for emergency medical services (EMS) personnel or clinicians, but the appropriate duration of CPR is not clear.
Goto added that clinicians have raised concerns that lengthy resuscitation efforts might be futile. They investigated how long CPR should be conducted to achieve maximum survival and favourable neurological outcome.
The European Society of Cardiology study found that the probability of survival declined with each minute of CPR (Figure 1). It also showed that 99.1 percent of all survivors and 99.2 percent of survivors with favourable neurological outcomes achieved return of spontaneous circulation within 35 minutes of EMS-initiated CPR (Figure 2). No patient with a CPR duration of 53 minutes survived one month after cardiac arrest (Figure 2).
Goto noted that the study shows that EMS personnel or clinicians should continue CPR for at least 35 minutes in patients who suffer cardiac arrest outside the hospital. More than 99 percent of survivals and favourable neurological outcomes were achieved by 35 minutes with minimal gains afterwards.
He concluded that they hope the findings give EMS personnel and clinicians the confidence that if they stop CPR after 35 minutes they have done everything they can do for a patient. This should help them know when it is appropriate to move on to the next medical emergency.
