News | March 07, 2013

Longer CPR Improves Survival in Both Children and Adults, Study Says

March 7, 2013 — Experts from The Children's Hospital of Philadelphia were among the leaders of two large national studies showing that extending cardiopulmonary resuscitation (CPR) longer than previously thought useful saves lives in both children and adults. The research teams analyzed the impact of CPR duration in patients who suffered cardiac arrest while hospitalized.

"These findings about the duration of CPR are game-changing, and we hope these results will rapidly affect hospital practice," said Robert A. Berg, M.D., chief of critical care medicine at The Children's Hospital of Philadelphia. Berg is the chair of the scientific advisory board of the American Heart Association's Get With Guidelines-Resuscitation program (GWTG-R). That quality improvement program is the only national registry that tracks and analyzes resuscitation of patients after in-hospital cardiac arrests.

The investigators reported data from the GWTG-R registry of CPR outcomes in thousands of North American hospital patients in two landmark studies — one in children, published in January 2013, the other in adults, published in October 2012.

Berg was a co-author of the pediatric study, appearing online in Circulation, which analyzed hospital records of 3,419 children in the United States and Canada from 2000 through 2009. This study, whose first author was Renee I. Matos, M.D., M.P.H., a mentored young investigator, found that among children who suffered in-hospital cardiac arrest, more children than expected survived after prolonged CPR, defined as CPR lasting longer than 35 minutes. Of those children who survived prolonged CPR, more than 60 percent had good neurologic outcomes.

The conventional thinking has been that CPR is futile after 20 minutes, but Berg said these results challenge that assumption.

In addition to Berg, two other co-authors are critical care and resuscitation science specialists at The Children's Hospital of Philadelphia: Vinay M. Nadkarni, M.D., and Peter A. Meaney, M.D., M.P.H.

Nadkarni noted that illness categories affected outcomes, with children hospitalized for cardiac surgery having better survival and neurological outcomes than children in all other patient groups.

The overall pediatric results paralleled those found in the adult study of 64,000 patients with in-hospital cardiac arrests between 2000 and 2008. Berg also was a co-author of that GWTG-R study, published in The Lancet on Oct. 27 and led by Brahmajee K. Nallamothu, M.D., M.P.H., of the University of Michigan. Patients at hospitals in the top quartile of median CPR duration (25 minutes) had a 12 percent higher chance of surviving cardiac arrest, compared to patients at hospitals in the bottom quartile of median CPR duration (16 minutes). Survivors of prolonged CPR had similar neurological outcomes to those who survived after shorter CPR efforts.

The American Heart Association and American Stroke Association designated the adult study as the top finding of the year in heart disease and stroke research in its annual list of major advances. Next steps for CPR researchers are to identify important risk and predictive factors that determine which patients may benefit most from prolonged CPR, and when CPR efforts have become futile.

"Taken together, the adult and pediatric results present a clear and hopeful message: persisting longer with CPR can offer better results than previously believed possible," concluded Berg.

For more information: www.chop.edu

Related Content

sudden cardiac arrest, out-of-hospital, comatose patients, University of Arizona study, wake up
News | Sudden Cardiac Arrest| July 13, 2016
Physicians may be drawing conclusions too soon about survival outcomes of patients who suffered a cardiac arrest...
ResQCPR System, resuscitation devices, cardiac arrest, CPR, FDA
Technology | March 09, 2015
The U.S. Food and Drug Administration (FDA) approved the ResQCPR System, a system of two devices for first responders...
Sudden cardiac arrest, resuscitation devices, AutoPulse, ZOLL

Image courtesy of Zoll

News | February 11, 2015
Zoll Medical Corporation, a manufacturer of medical devices and related software solutions, announced that RAV...
Feature | January 27, 2015
ECRI Institute has released an updated comparison on cardiac resuscitators used during cardiopulmonary resuscitation (...
Hemodynamic support devices, Resuscitation Devices, Zoll Medical Corp.

Image courtesy of Advanced Circulatory Systems

News | December 30, 2014
Zoll Medical Corp. announced that it will acquire Advanced Circulatory Systems Inc.
News | November 21, 2014
A coordinated emergency response by healthcare teams to treat heart attack patients meant faster care that was...
News | May 16, 2014
Advanced Circulatory, makers of medical devices providing Intrathoracic Pressure Regulation (IPR) Therapy, will...
therapeutic hypothermia, Philips InnerCool

The Philips InnerCool RTx system was used in the CHILL-MI study for use in STEMI patients.

Feature | February 03, 2014 | Dave Fornell
Use of therapeutic hypothermia is used to prevent neurological damage in patients who suffer sudden cardiac arrest (SCA...
resuscitation devices cath lab defibrillator monitors lucas device regions
News | October 22, 2013
A 56-year-old man who had a heart attack survived and is recovering at home after receiving two hours and forty-five...
Technology | September 25, 2013
Physio-Control launched its comprehensive solution designed to improve cardiac resuscitation in hospitals. The...
Overlay Init