Impact of ‘synchronous’ and ‘asynchronous’ CPR modality on quality bundles and outcome in out-of-hospital cardiac arrest patients

Sanson, Gianfranco; Ristagno, Giuseppe; Caggegi, Giuseppe Davide; Patsoura, A.; Xu, Veronica; Zambon, Marco; Montalbano, Domenico; Vukanovic, Sreten; Antonaglia, Vittorio

doi:10.1007/s11739-019-02138-9

Cited by 13 publications

(13 citation statements)

References 39 publications

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“…Malinverni et al reported that patients who were intubated did not have an associated increase in CCF over the entire duration of resuscitation when compared to patients managed with bag mask ventilation. 8 Other studies have shown that the use of the supraglottic airway during OHCA increases CCF when compared to standard bag mask ventilation 9 , 10 Advanced airway management is advantageous in that it allows asynchronous ventilation during resuscitation and reduces interruption of chest compressions, 11 the disadvantage is that, depending on the skill of the paramedic, securing the airway maneuver itself may take more time, which may in turn prolong the interruption of chest compressions. Differences in the style of pre-hospital rescue service and hospital transport times in countries and regions may have contributed to the variability in results.…”

Section: Discussionmentioning

confidence: 99%

Effect of Advanced Airway Management by Paramedics During Out-of-Hospital Cardiac Arrest on Chest Compression Fraction and Return of Spontaneous Circulation

Shimizu¹,

Wakasugi²,

Kawagishi³

et al. 2021

OAEM

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To obtain effective systemic blood flow and coronary perfusion by chest compressions during cardiopulmonary resuscitation, it is recommended that the interruption time of chest compressions be kept to a minimum, and that the chest compression fraction (CCF) should be kept high. In this study, we examined the effects of advanced airway management by paramedics in out-of-hospital cardiac arrest (OHCA) cases on CCF and on return of spontaneous circulation (ROSC) before arrival at the hospital. Participants and Methods: A total of 283 adult, non-traumatic OHCA cases who were in cardiopulmonary arrest at the time of EMS contact between April 2015 and March 2017 were registered for this study. We retrospectively investigated the presence or absence of advanced airway clearance, CCF and ROSC during CPR. CCF was calculated by measuring the chest compression interruption time from the ECG waveform recorded on a semiautomatic defibrillator (Philips HeartStart MRX). The data obtained were recorded on a computer, and comparisons between groups were examined using an untested t-test and χ 2 -test. Results: Of the 283 patients with OHCA, 159 were included in the analysis. The CCF of the AAM group was 89.4%, which was significantly higher than that in the BMV group (84.3%) (P<0.01). Forty-one patients had ROSC at the time of arrival at the hospital, and the CCF of ROSC patients was 89.7%, which was significantly higher than that of non-ROSC patients (87.2%) (P<0.01). ROSC was also obtained in 31.8% of the patients in the AAM group, which was significantly higher than that in the BMV group (12.2%). Conclusion:In this study, we found that advanced airway management during prehospital emergency transport by paramedics showed high CCF and ROSC rates and contributed to improving the prognosis of OHCA patients through high-quality resuscitation.

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Section: Discussionmentioning

confidence: 99%

Effect of Advanced Airway Management by Paramedics During Out-of-Hospital Cardiac Arrest on Chest Compression Fraction and Return of Spontaneous Circulation

Shimizu¹,

Wakasugi²,

Kawagishi³

et al. 2021

OAEM

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“…In our study, no statistically significant difference was found between both scenarios in terms of mean compression rate, compression depth, compression ratio at a sufficient rate, compression ratio with a complete return of rib cage, and compression ratio in sufficient depth. In the studies conducted by Nichol et al 12 and Manrique et al, 13 no statistically significant difference was found between the two scenarios in terms of compression depth and compression rate, while Sanson et al 14 Under the guidance of current guides, 3,4 in the study conducted by Sanson et al, 14 the survival rates of synchronous CPR, which were recommended at times when no advanced airway method was applied, were found to be lower compared to asynchronous or Nichol et al 12 did not found any significant difference. Since we performed this study using a medical-mannequin, we were not able to determine the survival rates.…”

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 92%

Comparison of cardiopulmonary resuscitation that applied synchronous 30 compressions–2 ventilations with that applied asynchronous 110/min compression–10/min ventilation: A mannequin study

Küçükceran

Ayrancı

Dündar

2023

Hong Kong j. emerg. med.

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Background: CPR model of a resuscitation to be ventilated with a bag valve mask constitutes a discussion when evaluated with the current guidance. Objective: This study aims to compare the synchronous (30–2) ventilation–compression method with asynchronous 110/min compression–10/min ventilation in cardiac arrests where an advanced airway management is not applied and where ventilation is provided by a bag valve mask on a mannequin. Methods: This simulation trial was performed using two clinical cardiopulmonary resuscitation scenarios: an asynchronous scenario with 10 ventilations per minute asynchronously when compression is applied as 110 compression per minute and a synchronous scenario in which 30 compressions:2 ventilations were performed synchronously. A total of 100 people in 50 groups applied these two scenarios on mannequin. Ventilation and compression data of both scenarios were recorded. Results: Evaluating the compression criteria in both the scenarios performed by 50 groups in total, in terms of all criteria except compression fraction, there was no statistically difference between the two scenarios (p > 0.05). Compression fraction values in the asynchronous scenario were found to be statistically significantly higher than the synchronous scenario (96.02 ± 2.35, 81.34 ± 4.42, p < 0.001). Evaluating the ventilation criteria in both the scenarios performed by 50 groups in total; there was a statistically significant difference in all criteria. Mean ventilation rate of the asynchronous scenario was statistically higher than the synchronous scenario (7.22 ± 2.42, 5.08 ± 0.75, p < 0.001). Mean ventilation volume of the synchronous scenario was statistically higher than the asynchronous scenario (353.24 ± 45.46, 527.40 ± 96.60, p < 0.001). Ventilation ratio in sufficient volume of the synchronous scenario was statistically higher than the asynchronous scenario (36.84 ± 14.47, 75.00 ± 21.24, p < 0.001). Ventilation ratio below the minimum volume limit of the asynchronous scenario was statistically higher than the synchronous scenario (62.48 ± 14.72, 17.86 ± 19.50, p < 0.001). Conclusion: In our study, we concluded that the cardiopulmonary resuscitation applied by the synchronous method reached better ventilation volumes. Evaluating together with any interruption in compression, comprehensive studies are needed to reveal which patients would benefit from this result.

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“…Our search strategy yielded a total of 291 records. After duplicate removal and records screening, a total of 42 studies were considered eligible, of which 26 original articles published in peer-reviewed journals, 2 , 5 , 11 , 12 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 10 abstracts presented at national or international congresses, 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 and six theses 48 , 49 , 50 , 51 , 52 , 53 ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Incidence, characteristics, and outcome of out-of-hospital cardiac arrest in Italy: A systematic review and meta-analysis

Scquizzato¹,

Gamberini²,

D’Arrigo³

et al. 2022

Resuscitation Plus

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Impact of ‘synchronous’ and ‘asynchronous’ CPR modality on quality bundles and outcome in out-of-hospital cardiac arrest patients

Cited by 13 publications

References 39 publications

Effect of Advanced Airway Management by Paramedics During Out-of-Hospital Cardiac Arrest on Chest Compression Fraction and Return of Spontaneous Circulation

Effect of Advanced Airway Management by Paramedics During Out-of-Hospital Cardiac Arrest on Chest Compression Fraction and Return of Spontaneous Circulation

Comparison of cardiopulmonary resuscitation that applied synchronous 30 compressions–2 ventilations with that applied asynchronous 110/min compression–10/min ventilation: A mannequin study

Incidence, characteristics, and outcome of out-of-hospital cardiac arrest in Italy: A systematic review and meta-analysis

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