Physical fitness affects the quality of single operator cardiocerebral resuscitation in healthcare professionals

Abstract

Objective Sustained external chest compressions during cardiocerebral resuscitation (CCR) are physically demanding. It might be hypothesized that a high cardiopulmonary exercise capacity and/or muscle strength delays the development of physical fatigue and, consequently, preserves CCR quality. We intended to assess the impact of cardiopulmonary exercise capacity and muscle strength on CCR quality.Methods Fifteen healthcare professionals (10 men and five women, mean age 34 ± 9 years) performed a 15-min hands-on CCR session on an adult training manikin. CCR compression depth (from which CCR quality was calculated) and frequency were monitored. During CCR we assessed serial blood lactate concentrations, and provided continuous heart rate monitoring. Relationships were examined between participant characteristics, peak cardiopulmonary exercise capacity, ventilatory threshold, maximal muscle strength, muscle strength endurance and CCR quality.Results Significant univariate correlations were found between 15-min CCR quality and body height (r = 0.53), ventilatory threshold (r = 0.67), peak oxygen uptake capacity (r = 0.54), peak cycling power output (r = 0.54), and maximal isometric elbow extension strength (r = 0.55) (P < 0.05). CCR quality was significantly lower in females, when compared with males (P < 0.05). Within different timeframes, CCR quality was mainly related to the ventilatory threshold up to the first 5 min (P < 0.05), whereas CCR quality was mainly related to maximal isometric elbow extension strength after 5 min (P < 0.05).Conclusion In healthcare professionals, the ventilatory threshold is significantly related to CCR quality during the first few min. Healthcare professionals who are regularly involved in CCR should therefore aim to achieve/sustain a high aerobic exercise capacity.

Depth and rate of chest compression in CPR simulation during 10-minute continuous external cardiac compression

“…The authors of this study are aware of the fact that it would be difficult to preselect candidates for the profession of a medical rescuer. However, according to the findings of this article and other sources [7,8,9], it would be advisable to preferably accept well-built candidates of a certain body fitness. Inefficient chest compression depth is difficult to be objectively justified.…”

“…It has also been pointed out that the increasing fatigue of the rescuer has an impact on the quality of chest compression and may be difficult to perform by physically unprepared individuals who do not always have the sufficient skills [7,8,9,10]. The 2010 AHA guidelines emphasize a compression rate of at least 100/min and a compression depth of at least 2 inches (5 cm) [1,6,11].…”

Rescuer factors predict high-quality CPR—a manikin-based study of health care providers

“…Hasegawa et al [11] showed that increased fatigue led to falling quality of chest compressions in a lighter body weight group among 18 nurses. Hansen et al [12] observed 15 health care professionals in a 15-minute handson CPR session on a manikin and demonstrated significant correlations between chest compression quality and body height in addition to physical fitness and muscle strength. In contrast, Ock et al [13] found that muscle strength was the only factor affecting CPR quality among 47 participants.…”

“…Therefore, factors associated with the rescuer's ability to perform high-quality chest compressions are of major concern. Previous studies have identified several factors associated with CPR quality, including the rescuer's body weight, body height, physical fitness, and muscle strength [11][12][13]. Hasegawa et al [11] showed that increased fatigue led to falling quality of chest compressions in a lighter body weight group among 18 nurses.…”

The effect of strength training on quality of prolonged basic cardiopulmonary resuscitation

“…European Resuscitation Council (ERC) guidelines have acknowledged this evidence and recommend a switch of rescuers every 2 min [1]. CC quality has been related to the upper extremity and trunk strength [11][12][13], but no studies have been done to ascertain the effect of power training specifically designed to increase the strength of the muscles used in CPR.…”