Delayed high-quality CPR does not improve outcomes

Song, Fengqing; Sun, Shijie; Ristagno, Giuseppe; Yu, Tao; Shan, Yi; Chung, Sung Phil; Weil, Max Harry; Tang, Wanchun

doi:10.1016/S0300-9572(11)70152-6

« PreviousResuscitation
Volume 82, Supplement 2 , Pages S52-S55, December 2011

Delayed high-quality CPR does not improve outcomes

Fengqing Song
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
Shijie Sun
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
- The Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Giuseppe Ristagno
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
Tao Yu
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
Yi Shan
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
Sung Phil Chung
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
Max Harry Weil
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
- The Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Wanchun Tang
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
- The Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
- Address for correspondence: Wanchun Tang, MD, Weil Institute of Critical Care Medicine, 35100 Bob Hope Drive, Rancho Mirage, CA, 92270, USA. Tel.: +1-760-778-4911; fax: +1 760-778-3468

Abstract

Aim of study

The quality of cardiopulmonary resuscitation (CPR) is an important factor in the outcome of cardiac arrest. Our objective was to compare outcomes following either immediate low-quality (LQ) CPR or delayed high-quality (HQ) CPR. We hypothesized that delayed HQ CPR will improve the outcomes of CPR in comparison to immediately performing LQ CPR.

Methods

Eighteen Sprague-Dawley rats were randomized into two groups: (1) Delayed HQ CPR (HQ group, n = 9). (2) Immediate LQ CPR (LQ group, n = 9). Ventricular fibrillation (VF) was induced and untreated for 8 mins. CPR was immediately performed in LQ group for 5 mins. Compression depth was set at 70% of the “optimal compression depth”. VF was untreated for an additional 5 mins in HQ group. HQ CPR was started together with ventilation (100% oxygen) and external hypothermia for 8 mins in both groups. The “optimal compression depth” was approximately 30% of the anteroposterior chest diameter. Epinephrine was administrated 3 mins prior to defibrillation attempt. Restoration of spontaneous circulation, postresuscitation myocardial function and survival time were monitored.

Results

All animals in the LQ group and 7 of 9 animals in the HQ group were resuscitated. Myocardial function, including ejection fraction and cardiac output was better in the LQ group than in the HQ group (p < 0.05) and survival time was longer in the LQ group (p < 0.05).