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Longer CPR duration may work for some patients

Friday September 7, 2012
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Longer attempts at performing CPR might be beneficial for some patients, according to a study.

Cardiac arrest patients often are successfully resuscitated after a short period of time — about 12 minutes on average. But researchers with the University of Michigan Health System found that for some patients, successful resuscitation only occurred after 30 minutes or more.

On a broader level, the researchers found that patients at hospitals where attempts were longer, on average, had a higher likelihood of immediate survival and survival to discharge, even after accounting for differences in overall patient characteristics. Patients who survived with longer arrest times did not appear to have substantially worse neurological function at discharge.

Each year about 200,000 hospitalized patients will experience cardiac arrest, with only half surviving the initial arrest and fewer than 20% surviving to discharge, according to background information in the study, which appeared Sept. 4 on the website of The Lancet.

Zachary D. Goldberger, MD, MS, the studyís lead author and formerly a Robert Wood Johnson Foundation cardiology fellow at U-M, said the wide variation among hospitalís average length of resuscitation attempts is not surprising. No firm evidence exists to guide practitioners on when to stop their resuscitative efforts.

"Our findings suggest an opportunity for improving care in this high-risk population," Goldberger, currently an assistant professor at the University of Washington, said in a news release. "Overall, it may involve standardizing the time required for continuing resuscitation attempts prior to decisions regarding termination of efforts."

Steven L. Kronick, MD, MS, a study coauthor and physician head of the CPR committee in the U-M ED, said the research should be a part of ongoing efforts to improve care for cardiac arrest patients.

"The optimal resuscitation duration for any individual patient will continue to remain a bedside decision that relies on careful clinical judgment," Kronick said. "Overall, we believe these findings present an opportunity to improve resuscitation care, especially at a systems level."

The study abstract is available at www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2960862-9/abstract.

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