Idris Ahamed H, Guffey Danielle, Pepe Paul E, Brown Siobhan P, Brooks Steven C, Callaway Clifton W, Christenson Jim, Davis Daniel P, Daya Mohamud R, Gray Randal, Kudenchuk Peter J, Larsen Jonathan, Lin Steve, Menegazzi James J, Sheehan Kellie, Sopko George, Stiell Ian, Nichol Graham, Aufderheide Tom P
1Departments of Emergency Medicine and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX. 2Clinical Trials Center, Department of Biostatistics, University of Washington, Seattle, WA. 3Departments of Emergency Medicine, Surgery, Internal Medicine and Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX. 4Department of Emergency Medicine, Queen's University, Toronto, Ontario, Canada. 5Department of Emergency Medicine, University of Pittsburgh, PA. 6Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada. 7Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, CA. 8Department of Emergency Medicine, Oregon Health & Science University, Portland, OR. 9Department of Emergency Medicine, University of Alabama, Birmingham, AL. 10Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA. 11Seattle Fire Department, Seattle, WA. 12Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 13National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. 14Department of Emergency Medicine and Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada. 15Department of Medicine, University of Washington, Seattle, WA. 16Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI.
Crit Care Med. 2015 Apr;43(4):840-8. doi: 10.1097/CCM.0000000000000824.
Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions/min. A recent clinical study reported optimal return of spontaneous circulation with rates between 100 and 120/min during cardiopulmonary resuscitation for out-of-hospital cardiac arrest. However, the relationship between compression rate and survival is still undetermined.
Prospective, observational study.
Data is from the Resuscitation Outcomes Consortium Prehospital Resuscitation IMpedance threshold device and Early versus Delayed analysis clinical trial.
Adults with out-of-hospital cardiac arrest treated by emergency medical service providers.
None.
Data were abstracted from monitor-defibrillator recordings for the first five minutes of emergency medical service cardiopulmonary resuscitation. Multiple logistic regression assessed odds ratio for survival by compression rate categories (<80, 80-99, 100-119, 120-139, ≥140), both unadjusted and adjusted for sex, age, witnessed status, attempted bystander cardiopulmonary resuscitation, location of arrest, chest compression fraction and depth, first rhythm, and study site. Compression rate data were available for 10,371 patients; 6,399 also had chest compression fraction and depth data. Age (mean±SD) was 67±16 years. Chest compression rate was 111±19 per minute, compression fraction was 0.70±0.17, and compression depth was 42±12 mm. Circulation was restored in 34%; 9% survived to hospital discharge. After adjustment for covariates without chest compression depth and fraction (n=10,371), a global test found no significant relationship between compression rate and survival (p=0.19). However, after adjustment for covariates including chest compression depth and fraction (n=6,399), the global test found a significant relationship between compression rate and survival (p=0.02), with the reference group (100-119 compressions/min) having the greatest likelihood for survival.
After adjustment for chest compression fraction and depth, compression rates between 100 and 120 per minute were associated with greatest survival to hospital discharge.
心肺复苏指南建议胸外按压速率至少为每分钟100次按压。最近一项临床研究报告称，在院外心脏骤停的心肺复苏过程中，每分钟100至120次的速率能实现最佳的自主循环恢复。然而，按压速率与生存率之间的关系仍未确定。
前瞻性观察研究。
数据来自复苏结果联盟院前复苏阻抗阈值装置及早期与延迟分析临床试验。
由紧急医疗服务提供者治疗的院外心脏骤停成人患者。
无。
数据从紧急医疗服务心肺复苏最初五分钟的监护除颤器记录中提取。多元逻辑回归评估按按压速率类别（<80、80 - 99、100 - 119、120 - 139、≥140）划分的生存比值比，未调整以及按性别、年龄、是否有目击者、旁观者是否尝试进行心肺复苏、骤停位置、胸外按压分数和深度、初始心律及研究地点进行调整后的情况。有10371例患者的按压速率数据；其中6399例还有胸外按压分数和深度数据。年龄（均值±标准差）为67±16岁。胸外按压速率为每分钟111±19次，按压分数为0.70±0.17，按压深度为42±12毫米。34%恢复了循环；9%存活至出院。在对不包括胸外按压深度和分数的协变量进行调整后（n = 10371），整体检验发现按压速率与生存率之间无显著关系（p = 0.19）。然而，在对包括胸外按压深度和分数的协变量进行调整后（n = 6399），整体检验发现按压速率与生存率之间存在显著关系（p = 0.02），参照组（每分钟100 - 119次按压）的生存可能性最大。
在对胸外按压分数和深度进行调整后，每分钟100至120次的按压速率与存活至出院的最高可能性相关。
