jueves, 13 de diciembre de 2012

CPR Update

CPR Update

CPR Update

New on the MedlinePlus CPR page:
12/10/2012 04:00 PM EST

Used with automatic defibrillator, chest compression alone helped people survive cardiac arrest
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Source: HealthDay
Compression-only CPR improves survival with good brain function / American Heart Association

Compression-only CPR improves survival with good brain function

Study Highlights:
  • A new Japanese study shows that early compression-only CPR, without rescue breathing, kept more people alive with good brain function after they had a sudden cardiac arrest.
  • Survival rates of more than 40 percent were noted when cardiac arrests were observed, bystanders provided early compression-only CPR, and an electric shock was given from a publicly accessed defibrillator.
EMBARGOED UNTIL 4 pm ET, Monday, December 10, 2012
DALLAS, Dec. 10, 2012 — Chest compression-only CPR performed by bystanders — without rescue breathing — keeps more people alive with good brain function after having a sudden cardiac arrest External link, according to a Japanese study reported in Circulation: Journal of the American Heart Association.
 
Sudden cardiac arrest is the abrupt loss of heart function, usually resulting from an irregular heart rhythm.
 
Compression-only CPR from bystanders should start immediately after the cardiac arrest, followed by a shock with an automated external defibrillator External link, or AED, said Taku Iwami, M.D., Ph.D., study lead author and senior lecturer in the Department of Preventive Services at Kyoto University School of Public Health in Japan.
 
“Early initiation of CPR and shocks from a public access AED are the keys to saving lives from sudden cardiac arrest,” he said.
 
An AED is a portable device that delivers an electric shock to reestablish an effective heartbeat. These devices are available in public areas in the United States and in countries like Japan where the study was conducted.
 
Researchers analyzed the records of 1,376 people in Japan who had sudden cardiac arrests between 2005 and 2009 that were witnessed and received CPR and AED shocks from bystanders. Of these arrests, 36.8 percent received compression-only CPR and 63.2 percent received conventional CPR with chest compressions and breaths.
 
When comparing survivors after one month, researchers found:
  • More than 46 percent (46.4) of the compression-only CPR patients were alive, compared to 39.9 percent of those who received conventional CPR.
  • The chest-compression-only CPR led to 40.7 percent of patients having favorable brain function compared to 32.9 percent of those who received traditional CPR. Patients were considered to have favorable neurological status if they had normal brain function or if they lived independently — even if they had some neurological impairment.
In addition to the improved outcomes, performing CPR with chest compressions only is also preferable because it’s easier to learn and preferred by those uncomfortable with mouth-to-mouth rescue breathing, Iwami said.
 
“Rescue breathing is difficult for some people to perform and might interrupt chest compressions,” he said.
 
The study results also apply to people in the United States and other countries, Iwami said. “Most victims don’t receive any CPR, so we need to encourage chest-compression-only CPR and public access defibrillation programs.”
 
The study reports that the combination of early defibrillation with public-access AEDs and compression-only CPR provided by bystanders in witnessed cardiac arrest can provide neurologically favorable survival rates of over 40 percent.
 
“Across the United States, too many people are dying from sudden cardiac arrest because family members and friends of the victim are unsure how to help. This study confirms that Hands-Only CPR is highly effective. Plus it’s easy to do,” said Michael Sayre, M.D., national spokesperson for the American Heart Association and Professor of Emergency Medicine at the University of Washington.
 
The American Heart Association recommends that bystanders do Hands-Only CPR – pushing hard and fast in the center of a victim’s chest – if they see an adult suddenly collapse.
 
Iwami said further studies are needed on whether bystanders should perform compression-only CPR on children.
 
For infants (up to age one) and children (up to puberty), the association recommends CPR with a combination of breaths and compressions.
 
Co-authors are: Tetsuhisa Kitamura, M.D., M.Sc., Dr.P.H.; Takashi Kawamura, M.D., Ph.D.; Hideo Mitamura, M.D., Ph.D.; Ken Nagao, M.D., Ph.D.; Morimasa Takayama, M.D., Ph.D.; Yoshihiko Seino, M.D., Ph.D.; Hideharu Tanaka, M.D., Ph.D.; Hiroshi Nonogi, M.D., Ph.D.; Naohiro Yonemoto, Dr.P.H.; and Takeshi Kimura, M.D., Ph.D. Author disclosures are on the manuscript. The study received no outside funding.
 
Learn more about the American Heart Association’s Hands-Only™ CPR External link campaign. In addition, read the association’s 2008 scientific statement External link PDF file recommending Hands-Only CPR.
 
For the latest heart and stroke news on Twitter, follow @HeartNews External link.
 
###
 
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position.  The association makes no representation or guarantee as to their accuracy or reliability.  The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events.  The association has strict policies to prevent these relationships from influencing the science content.  Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding External link.
 
Additional resources, including multimedia, are available in the right column.
 
For Media Inquiries: (214) 706-1173
Tagni McRae: (214) 706-1383; Tagni.McRae@heart.org
Bridgette McNeill: (214) 706-1135; Bridgette.McNeill@heart.org
Julie Del Barto (broadcast): (214) 706-1330; Julie.DelBarto@heart.org
For Public Inquiries: (800) AHA-USA1 (242-8721)
 
 
 
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Eliminating Mouth-to-Mouth Boosts CPR Results: Study

Used with automatic defibrillator, chest compression alone helped people survive cardiac arrest
URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_132098.html (*this news item will not be available after 03/10/2013)
Monday, December 10, 2012 HealthDay Logo
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Related MedlinePlus Page
MONDAY, Dec. 10 (HealthDayNews) -- Bystander CPR saves more lives when just chest compression is performed without mouth-to-mouth resuscitation, a new study from Japan shows.
Followed by use of easy-to-use publicly available defibrillators, chest compression alone kept more people alive with good brain function than traditional CPR (cardiopulmonary resuscitation) with mouth-to-mouth rescue breathing, the study found.
"We would like to suggest that compression-only CPR should be the standard and conventional CPR with rescue breathing the option," said lead investigator Dr. Taku Iwami, a senior lecturer in the department of preventive services at Kyoto University School of Public Health.
When someone suffers cardiac arrest, the heart stops beating. Experts say the findings are welcome news because many people don't want to perform mouth-to-mouth breathing or are unable to perform chest compressions and rescue breathing at the same time.
For the study, published Dec. 10 in the journal Circulation, Iwami's team looked at the medical records of more than 1,300 people who suffered out-of-hospital cardiac arrests from 2005 to 2009.
In each case, the arrest was witnessed, and bystanders gave CPR and shocks from an automatic defibrillator (AED).
Almost 37 percent of the victims received only chest compressions, while the others got traditional CPR -- chest compressions and rescue breathing.
In the month after their cardiac arrest, about 46 percent of those who received chest compressions alone were still alive, compared with about 40 percent of those who got traditional CPR, the researchers found.
Moreover, of those given chest compressions alone, more than 40 percent retained good brain function, compared with around 33 percent of those given compressions and rescue breathing, they added.
One expert supported the findings.
"This is very encouraging because it shows that simple actions like starting CPR with just chest compressions really made a positive difference and saved lives," said Dr. Michael Sayre, a professor of emergency medicine at the University of Washington in Seattle.
Since 2008, the American Heart Association has recommended that when someone sees a person go into cardiac arrest, chest compression alone should be started. But Iwami said the matter was controversial, and the study was conducted to determine whether chest compression alone is effective.
Sayre said that if chest compressions are started almost immediately, there is enough air in the victim's lungs to supply oxygen to the body.
Availability of an automated external defibrillator (AED) -- a portable device that delivers an electric shock to restart the heart -- is crucial to the patient's survival, he said. AEDs are available in public areas in the United States and in other countries including Japan.
"It's the combination that makes a big difference," he said.
"Doing something is always better than doing nothing," Sayre added. "So, if you see someone collapse, start pushing hard and fast on the center of their chest."
Another expert, Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, noted that the majority of the people who suffered bystander-witnessed cardiac arrests during the study period did not receive any type of CPR or public access defibrillation.
That highlights "the critical need for global improvement in individuals trained and willing to perform chest compression-only CPR and increased access to automatic external defibrillator devices," he said.
Iwami agreed. "We should implement programs to increase the number of lay rescuers who can at least perform chest compressions and use an AED," he said.
However, in certain cases, traditional CPR is still preferable. For infants and children, for instance, the American Heart Association still recommends CPR with a combination of breaths and compressions.
Iwami said further studies are needed on whether bystanders should perform compression-only CPR on children.
SOURCES: Taku Iwami, M.D., Ph.D., senior lecturer, Department of Preventive Services, Kyoto University School of Public Health, Japan; Gregg Fonarow, M.D., spokesman, American Heart Association, and professor, cardiology, University of California, Los Angeles; Michael Sayre, M.D., spokesperson, American Heart Association, professor of emergency medicine, University of Washington, Seattle; Dec. 10, 2012, Circulation
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