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Bystander CPR up to 10 minutes after cardiac arrest can protect brain function

The sooner a lay rescuer (bystander) begins cardiopulmonary resuscitation (CPR) on a person in cardiac arrest at home or in public, up to 10 minutes after the arrest, the better the chances of saving the person’s life and protecting their brain function. according to preliminary research to be presented at the American Heart Association’s 2024 Resuscitation Sciences Symposium. The meeting will be held November 16-17, 2024 at the Hilton Chicago Hotel in Chicago and will present the latest advances related to the treatment of cardiopulmonary arrest and life-threatening traumatic injuries.

Cardiac arrest, which occurs when the heart malfunctions and abruptly stops beating, is often fatal without quick medical care, such as CPR to increase blood flow to the heart and brain. More than 357,000 out-of-hospital cardiac arrests occur each year in the US with a survival rate of 9.3%. “Our findings reinforce that every second counts when initiating bystander CPR and even a delay of a few minutes can make a big difference,” said Evan O’Keefe, MD, first author of the study and a cardiovascular fellow at Saint Luke’s. Mid America Heart Institute and the University of Missouri-Kansas City. “If you see someone in need of CPR, don’t worry about how long they’ve been down, your quick actions could save their life.”

The study analyzed nearly 200,000 cases of witnessed out-of-hospital cardiac arrest to determine whether initiating CPR at different time periods, compared to outcomes without administering bystander CPR, made a difference in survival and function. brain after hospital discharge.

“We found that people who received bystander CPR within the first few minutes of their cardiac arrest were much more likely to survive and have better brain function than those who did not receive it,” O’Keefe said. “The longer it took to start CPR, the less survival benefit was received. However, even when CPR was started up to 10 minutes after cardiac arrest, there was still a significant survival benefit compared to people who did not. “They received CPR from a bystander.”

Results were also found:

  • People who received CPR within two minutes of out-of-hospital cardiac arrest had an 81% higher survival rate to hospital discharge and a 95% higher survival rate without significant brain damage compared to people who did not receive CPR. Bystander CPR.
  • Even people who received bystander CPR up to 10 minutes after cardiac arrest were 19% more likely to survive to hospital discharge and 22% more likely to have a favorable neurological outcome than those who did not receive any. Bystander CPR.
  • For those who did not receive bystander CPR, about 12 percent survived to be discharged from the hospital, and more than 9 percent survived without significant brain damage or major disabilities. When bystander CPR was initiated more than 10 minutes after cardiac arrest, bystander CPR, compared with no life-saving assistance, was no longer associated with improved survival.

“These results highlight the critical importance of quick action in emergencies. They suggest that we should focus on teaching more people how to perform CPR, and we should also emphasize ways to more quickly help those in cardiac arrest,” O’Keefe said. saying. “This could include more widespread CPR training programs, as well as better public access to automated external defibrillators (AEDs) and improved dispatch systems.”

O’Keefe noted that future research could explore how technology (such as apps that alert nearby trained bystanders or alert operators to possible cardiac arrest) can help reduce time to first intervention, information that could be important for clinicians. emergency operators and policymakers in development. of public interventions for cardiac arrest.

“This study highlights the need for bystanders to quickly recognize and treat cardiac arrest. Time is of the essence when cardiac arrest occurs, and late interventions can be as ineffective as no intervention. Community education and empowerment are critical for us to save lives,” said American Heart Association volunteer expert Dr. Anezi Uzendu, an interventional cardiologist at the University of Texas Southwestern Medical Center in Dallas and a cardiac arrest survivor.

The American Heart Association urges everyone to learn the lifesaving skills of CPR and join its Nation of Lifesavers®, a movement to double survival rates from sudden cardiac arrest by 2030. Being prepared to act quickly could be the life or death difference for someone experiencing cardiac arrest.

A limitation of the study includes that the average arrival time of emergency medical technicians (EMTs) to the person in cardiac arrest was approximately 10 minutes. This means that in this study, people who received bystander CPR 10 minutes after their cardiac arrest were likely compared to a group that received professional medical care.

Study details and background:

  • The study identified 160,822 witnesses to out-of-hospital cardiac arrests that occurred between 2013 and 2022. Among the people whose data was analyzed, the average age was 64 years and more than 54,000 (about 34%) were women.
  • The researchers used data from the Cardiac Arrest Registry to Improve Survival (CARES), a national web-based health registry focused on helping communities improve out-of-hospital cardiac arrest care and survival.
  • The research categorized the time to initiation of bystander CPR into two-minute intervals and looked at the link between each time interval, compared to the group that did not receive CPR, with survival to hospital discharge and favorable neurological survival, or survival with minor disabilities.

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