Aug 9, 2006

Three-phase model of cardiac arrest: time-dependent benefit of bystander cardiopulmonary resuscitation

The American Journal of Cardiology
Christina M GilmoreMickey Eisenberg


Evidence has suggested that the pathophysiology of ventricular fibrillation cardiac arrest may consist of 3 time-sensitive phases: electrical, circulatory, and metabolic. We performed a retrospective cohort study of adults in a metropolitan county who had had witnessed ventricular fibrillation arrest before emergency medical services were undertaken to investigate this 3-phase model with regard to bystander cardiopulmonary resuscitation (CPR). We hypothesized that the survival benefit from bystander CPR depends on the collapse-to-shock interval, with the highest benefit occurring during the circulatory phase. The collapse-to-shock interval was a priori grouped into 4 categories: 1 to 5, 6 to 7, 8 to 10, and > or = 11 minutes. We used logistic regression analysis to assess whether the association between CPR and survival to hospital discharge depended on the collapse-to-shock interval category. Of the 2,193 events meeting the inclusion criteria, 67.0% had received bystander CPR. The average collapse-to-shock interval was 8.2 +/- 2.8 minutes. The survival rate was 33.4%. A higher likelihood of survival was associated with bystander CPR (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.15 to 1.73) and a shorter collapse-to-sho...Continue Reading

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Mentioned in this Paper

Metabolic Process, Cellular
Ventricular Fibrillation
Circulatory System
Basic Cardiac Life Support
Odds Ratio
Blood Circulation
Regression Analysis
Retrospective Studies

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