- During in-hospital cardiac arrest (IHCA) with return of spontaneous circulation (ROSC), briefer CPR is associated with better survival.
- However, CPR duration is not a reliable marker of futility in such resuscitations.
Why this matters
- Some 200,000 IHCA resuscitations occur annually in the United States.
- Optimum duration of resuscitation attempt is unknown.
- How duration of resuscitation relates to mortality has been unclear.
- 30-day survival was 471 (56%).
- Among 768 (91%) of 840 immediate survivors, median CPR duration was 5 minutes (interquartile range, 2-12 minutes).
- Factors associated with survival:
- Arrest in cath lab, regardless of duration;
- Witnessed arrests in Q1, Q2;
- Shockable rhythm, regardless of duration.
- Survival vs Q1 (aOR):
- Q2: 0.69 (95% CI, 0.37-1.29);
- Q3: 0.35 (0.19-0.65);
- Q4: 0.10 (0.05-0.20).
- 90%, 95%, and 99% of survivors underwent CPR for ≤15, 20, and 60 minutes, respectively.
- In Q4, 30% survived to ≥30 days.
- Hospital-based retrospective cohort study of 840 consecutive adults experiencing IHCA with ROSC during 10-year period at Sweden's Karolinska University Hospital.
- Researchers stratified survivors by quartile according to CPR duration:
- Q2: 3-5 minutes;
- Q3: 6-12 minutes;
- Q4: ≥13 minutes.
- Outcome was 30-day survival.
- Funding: Karolinska Institutet.
- Potential residual confounding from post-ROSC treatments.