J Korean Med Sci.  2016 Sep;31(9):1491-1498. 10.3346/jkms.2016.31.9.1491.

A Randomized Controlled Trial of Compression Rates during Cardiopulmonary Resuscitation

• Hwang SO
• Cha KC
• Kim K
• Jo YH
• Chung SP
• You JS
• Shin J
• Lee HJ
• Park YS
• Kim S
• Choi SC
• Park EJ
• Kim WY
• Seo DW
• Moon S
• Han G
• Choi HS
• Kang H
• Park SM
• Kwon WY
• Choi E

• KMID: 2468285
• DOI: http://doi.org/10.3346/jkms.2016.31.9.1491

Abstract

The objective of this study was to compare the efficacy of cardiopulmonary resuscitation (CPR) with 120 compressions per minute (CPM) to CPR with 100 CPM in patients with non-traumatic out-of-hospital cardiac arrest. We randomly assigned patients with non-traumatic out-of-hospital cardiac arrest into two groups upon arrival to the emergency department (ED). The patients received manual CPR either with 100 CPM (CPR-100 group) or 120 CPM (CPR-120 group). The primary outcome measure was sustained restoration of spontaneous circulation (ROSC). The secondary outcome measures were survival discharge from the hospital, one-month survival, and one-month survival with good functional status. Of 470 patients with cardiac arrest, 136 patients in the CPR-100 group and 156 patients in the CPR-120 group were included in the final analysis. A total of 69 patients (50.7%) in the CPR-100 group and 67 patients (42.9%) in the CPR-120 group had ROSC (absolute difference, 7.8% points; 95% confidence interval [CI], -3.7 to 19.2%; P = 0.183). The rates of survival discharge from the hospital, one-month survival, and one-month survival with good functional status were not different between the two groups (16.9% vs. 12.8%, P = 0.325; 12.5% vs. 6.4%, P = 0.073; 5.9% vs. 2.6%, P = 0.154, respectively). We did not find differences in the resuscitation outcomes between those who received CPR with 100 CPM and those with 120 CPM. However, a large trial is warranted, with adequate power to confirm a statistically non-significant trend toward superiority of CPR with 100 CPM. (Clinical Trial Registration Information: www.cris.nih.go.kr, cris.nih.go.kr number, KCT0000231)

Keyword

Cardiopulmonary Resuscitation; Cardiac Arrest; Basic Life Support

MeSH Terms

Age Factors
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation/*methods
Emergency Medical Services
Female
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest/mortality/*therapy
Patient Discharge
Sex Factors
Survival Analysis
Treatment Outcome

Figure

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  Fig. 1 Patient inclusion and groups. DOA, death on arrival; CPR-100, CPR with 100 CPM (compression per minute); CPR-120, CPR with 120 CPM.

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  Fig. 2 A forest plot of the relative predictions for primary outcome quantified by odds ratio using binary logistic regression.

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