Similar Survival with Continuous or Interrupted CPR for Out-of-Hospital Cardiac Arrest

By Ali Raja, MD, MBA, MPH, FACEP

Dr. Raja is an associate editor with NEJM Journal Watch Emergency Medicine, from which this story was adapted. See full coverage at the link below.

Continuous and interrupted high-quality chest compressions are equally effective in out-of-hospital cardiac arrest, according to a large trial presented at the American Heart Association's annual meeting and published in the New England Journal of Medicine. The 2015 AHA guidelines recommend continuous compressions.

In a cluster-randomized trial involving 114 emergency medical services agencies in North America, adults with nontraumatic cardiac arrest received either continuous compressions (100 compressions/minute with asynchronous positive-pressure ventilation at 10 ventilations/minute) or interrupted compressions (30 compressions followed by 2 positive-pressure ventilations). Other basic and advanced life support interventions were not standardized.

Among nearly 24,000 patients, rates of survival to hospital discharge were similar in the continuous and interrupted compression groups (9.0% and 9.7%). Compressions were delivered in the two groups at similar mean depth (about 5 cm) and speed (about 110 per minute). Mean pre- and post-shock pauses were the same in the two groups.

The take-home message is that high-quality CPR saves lives, regardless of compression strategy. No matter which compression/ventilation strategy is used, good communication within the team remains essential.