Experts agree that after
someone's heart stops, the sooner CPR is started the better the chances of
And now Japanese
researchers report that continuing CPR for a half hour or more may help more
victims survive with good brain function.
The study found that even
after 38 minutes of CPR, people could still recover and have good brain
The findings are scheduled for
presentation Saturday at the American Heart Association's annual meeting in
Not everyone is convinced
that performing CPR for longer periods is necessarily better, however. "I
think this study has to be looked at with a lot of caution. Thirty-eight
minutes is a long time, even for a young patient," said Dr Hector Medina,
a cardiologist at Scott and White Healthcare in Round Rock, Texas.
Difficult to come to firm conclusions
"In routine practice, after 30 minutes... we give really good thought about the feasibility of continuing the
resuscitation effort, particularly in older patients." Medina said that
because the study is being reported at a meeting and hasn't yet been published
in a peer-reviewed journal, it's difficult to come to any firm conclusions or
recommend changes to clinical practices.
To arrive at the findings,
the researchers reviewed data on more than 280 000 people who had experienced
cardiac arrest outside a hospital. When the patients' hearts stopped, there had
been at least one other person nearby.
The researchers then
narrowed that large group down to those whose hearts started beating on their
own after resuscitation. Doctors call this "return of spontaneous
circulation". This group included almost 32 000 people.
When the researchers
examined those patients 30 days after their cardiac arrest, they found that
just more than 27% had good brain function.
Those who had good brain
function averaged 13 minutes from the moment their heart stopped until their
heart started beating again on its own. Those with less favourable outcomes
averaged almost 22 minutes of resuscitation efforts before their hearts started
Some people even had favourable
outcomes after as long as 38 minutes of resuscitation efforts.
But, with each minute that
passed when the heart wasn't beating, the odds of surviving without severe brain
damage dropped by 5%.
Dr Suzanne Steinbaum, a
preventive cardiologist at Lenox Hill Hospital in New York City, weighed in on
the findings. "This study suggests that a return to spontaneous
circulation by 13 minutes offered the best neurological outcomes, and beyond 38
minutes probably won't have favourable neurological outcomes," she said.
Both experts said it
wouldn't be possible for one person to do 38 minutes of resuscitation care on
their own. In a hospital, Medina said, health care workers trade off every
three minutes or so because CPR is a pretty intense workout.
Steinbaum also said the
American Heart Association recently simplified its resuscitation care recommendations, and they're now suggesting that people practice hands-only
Hands-only CPR guidelines
advise calling 911 and then pushing hard and fast on the centre of the chest
(to the beat of the song "Stayin' Alive") until help arrives. Doing
hands-only CPR can double a person's chance of survival, according to the AHA.
Other research to be
presented at the same meeting on Saturday found that when people at a shopping
mall were shown a one-minute video detailing hands-only CPR, they were more
likely to call 911 if they witnessed someone collapse. They also were more
likely to initiate hands-only CPR sooner.
"Don't feel like you
can't do anything," Steinbaum said. "Call for help and start
Learn more about how you
can save someone's life at the American Heart Association.