Implementation of mechanical chest compression in out-of-hospital cardiac arrest in an emergency medical service system - 31/07/13
Abstract |
Aim |
The aim of this study is to describe the outcome changes after out-of-hospital cardiac arrest (OHCA) in Gothenburg, Sweden, after introduction of mechanical chest compression (MCC).
Methods |
Following introduction of MCC, 1183 OHCA patients were treated from November 1, 2007, to December 31, 2011 (period 2). They were compared with 1218 OHCA patients before MCC was introduced from January 1, 1998, to May 30, 2003 (period 1). Patients in period 2 were evaluated for survival in relation to MCC use.
Results |
The percentage of patients admitted to hospital alive increased from 25.4% to 31.9% (P < .0001). Survival to 1 month increased from 7.1% to 10.7% (P = .002) from period 1 to period 2. The proportion of ventricular fibrillation/ventricular tachycardia decreased in period 2 (P = .002). However, bystander cardiopulmonary resuscitation (P < .0001), crew-witnessed cases (P = .04), percutaneous coronary intervention (P < .0001), therapeutic hypothermia (P < .0001), and implantable cardioverter-defibrillator use (P = .01) increased, as did time from call to emergency medicine service arrival (P < .0001) and to defibrillation (P = .006).
In period 2, 60% of OHCA patients were treated with MCC. The percentages admitted alive to hospital (MCC vs no MCC) were 28.6% and 36.1% (P = .008). Corresponding figures for survival to 1 month were 5.6% and 17.6% (P < .0001). In the MCC group, we found increase in the delay from collapse to defibrillation (P < .0001), greater use of adrenaline (P < .0001), and fewer crew-witnessed cases (P < .0001).
Conclusion |
Survival to 1 month after implementation of MCC was higher than before introduction. However, patients receiving MCC had low survival. Although case selection might play a role, results do not support a widespread use of MCC after OHCA.
Le texte complet de cet article est disponible en PDF.Plan
| ☆ | Conflict of interest: None of the authors has any conflicts to declare. |
Vol 31 - N° 8
P. 1196-1200 - août 2013 Retour au numéro
Article précédent
- Predictive cutoff point of admission N-terminal pro–B-type natriuretic peptide testing in the ED for prognosis of patients with acute heart failure
- Yalcin Golcuk, Burcu Golcuk, Yalcin Velibey, Deniz Oray, Ozge Duman Atilla, Ayfer Colak, Yusuf Kurtulmus, Ayd?n Y?ld?r?m, Mehmet Eren
- Heart rate variability risk score for prediction of acute cardiac complications in ED patients with chest pain
- Marcus Eng Hock Ong, Ken Goh, Stephanie Fook-Chong, Benjamin Haaland, Khin Lay Wai, Zhi Xiong Koh, Nur Shahidah, Zhiping Lin
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?