Impact of cardiopulmonary resuscitation duration on the neurological outcomes of out-of-hospital cardiac arrest

Abstract

Background Patients experiencing cardiac arrest outside medical facilities are at greater risk of death and might have negative neurological outcomes. Cardiopulmonary resuscitation duration affects neurological outcomes of such patients, which suggests that duration of CPR may be vital to patient outcomes. Objectives The study aims to evaluate the impact of cardiopulmonary resuscitation duration on neurological outcome of patients who have suffered out-of-hospital cardiac arrest. Methods This is a quantitate cross-sectional study where data is collected from emergency cases handled by a secondary hospital in industrial Jubail, Saudi Arabia, between January 2015 and December 2020. There were 257 out-of-hospital cardiac arrest cases, 236 of which resulted in death. The outcome is the survival of OHCA or death, and the neurological outcome by the cerebral performance category (CPC) score for survivors. A score of 1 or 2 defined as good CPC outcome and 3, 4, and 5 as poor outcome. Results The mean for the duration of emergency CPR procedures in surviving patients is 26.5 ± 7.20 min, whereas in patients who died after the procedure it is 29.6 ± 9.15 min. Bivariate analysis showed no significant association between duration of CPR and Cerebral Performance Category (CPC) outcome but could be significant if the sample size is large. Age, however, is significantly related to the survivorship of OHCA and to a better CPC outcome. Younger patients are more likely to have better CPC outcome. A good CPC outcome was reported with a limited duration of 8.1 min of CPR, whereas, poor CPC outcomes were associated with prolonged periods of CPR, 13.2 min. Conclusion Cardiopulmonary Resuscitation Duration out-of-hospital cardiac arrest does not significantly influence the patient neurological outcome in the current study hospital. Variables such as the patient population's uniqueness, underlying medical conditions, or the specific study conditions may explain this variance between the bivariate analysis and the study conclusion. Therefore, a more comprehensive study is recommended in future.

Investigating the outcomes of cardiopulmonary resuscitation and factors affecting it: A cross‐sectional study at Dr. Moaven Hospital, Sahneh City from 2014 to 2021

“…Various studies show that the duration of CPR is related to the return of spontaneous circulation, that the greatest benefits of CPR can be obtained in the first 10−15 min, and that increasing the duration of CPR will bring minimal benefits, with the average duration of CPR in patients who had successful CPR being less than 30 min 32 . According to Albinali et al, the average duration of CPR in patients who survived was 26.5 min, which is similar to the current study 33 . Receiving a defibrillator had a statistically significant relationship with the outcome of CPR.…”

“…32 According to Albinali et al, the average duration of CPR in patients who survived was 26.5 min, which is similar to the current study. 33 Receiving a defibrillator had a statistically significant relationship with the outcome of CPR. 37.5% of VT patients who received a defibrillator returned to their cardiac rhythm and had a successful resuscitation, while 27.6% of Vf patients who received a defibrillator had a successful resuscitation.…”

Unfavorable Neurological Outcomes with Incremental Cardiopulmonary Resuscitation Duration in Cardiac Arrest Brain Injury: A Systematic Review and Meta-Analysis

“…While this study emphasizes the role of initial rhythm, other patient-related factors playing a role in neurological outcomes despite prolonged CPR, it is similar to our study in the fact that they also report that total CPR duration was inversely associated with a CPC of 1-2 at discharge. According to another study conducted in Saudi Arabia by Albnali et al, patient-related characteristics such as age and preexisting medical comorbidities were much more important than CPR time in determining the neurological outcome [16]. Despite these factors playing a role, they also report that shorter duration of CPR was associated with favorable neurological outcomes, as seen in our study.…”

What factors are effective on the CPR duration of patients under extracorporeal cardiopulmonary resuscitation: a single-center retrospective study

“…CPR is a lifesaving technique that combines chest compressions and rescue breaths to maintain circulation and oxygenation when the heart stops beating [ 33 ]. The duration of CPR plays a crucial role in determining the likelihood of a successful outcome in cardiac arrest patients [ 34 ]. Research has consistently demonstrated that shorter CPR duration is associated with higher survival rates and more favorable neurological outcomes [ 10 , 11 , 35 ].…”