Doctors Giving Up Too Soon? Prolonged CPR May Have Benefits Finds New Study
A new study published in The Lancet finds that patients survive in-hospital cardiac arrests if the cardio pulmonary resuscitation (CPR) was prolonged for more than the average time. The study raises uncomfortable questions on the standard practices of resuscitation without providing any concrete answers.
The study is unique since this is the first time that CPR rates have been linked to survival rates. It is one of the largest studies, and was funded by NIH, Robert Wood Johnson Foundation, and American Hospital Association.
The study is knocking at the doors of conventional practices and may force a review of conventional practices.
The lead author of the study, Dr. Zachary D. Goldberger told the New York Times,
One of the challenges we face during an in-hospital cardiac arrest is determining how long to continue resuscitation if a patient remains unresponsive. This is one area in which there are no guidelines.
The researchers, collected data of 65,000 cardiac arrest patients, in the time period of 2000-2008, from 435 US hospitals. Cases investigated included only patients in regular beds and ICU. Those admitted to EDs or those who suffered cardiac arrests during clinical procedures were not considered.
Salient Features Study Brings Forward
- There was significant variation in duration of CPR between hospitals.
- The median value ranged from 16 minutes to 25 minutes.
- This difference in time hospitals engaged in CPR for a patient was significant.
- Extra minutes spent on protracted resuscitation were not in vain.
- The minutes spent in excess made a positive difference.
- In-hospital patients with longest CPR efforts had a 12% higher survival rate than the ones with shortest times.
- However, neurological function was same, irrespective of CPR duration.
- Patients who did not respond to defibrillation benefited more from the prolonged CPR.
- Extra time spent on CPR may give doctors the opportunity to analyze situation and introduce interventions.
The study authors reiterate, that the study does not claim that longer CPR helps all patients, and that they were not able to come up or identify an optimal duration for all patients who suffer from in-hospital cardiac arrests.