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Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest

Alain Kalmar UGent, Jeroen De Smet, Emmanuel Annaert UGent, Melissa De Regge UGent, Paul Calle UGent and Koenraad Monsieurs UGent (2011) EUROPEAN JOURNAL OF ANAESTHESIOLOGY. 28(suppl. 48). p.5-5
abstract
Background and goal of study: In the latest Consensus on Science and Treatment Recommendations on Cardiopulmonary Resuscitation (ref), the relationship between compression rate and compression depth is considered to be a knowledge gap. In order to characterize this relationship, we performed an observational study in pre-hospital cardiac arrest patients. Materials and methods : In patients undergoing out-of-hospital cardiopulmonary resuscitation by health care professionals, chest compression rate and depth were recorded using an accelerometer (E-series monitor-defibrillator, Zoll, USA). The monitor provided real-time corrective feedback for compression rates <80/min and for depth <4 cm. Compression depth was analyzed for rates <80/min, 80-120/min and >120/min. A difference in compression depth ≥5 mm was considered potentially clinically significant. Results and discussion : Thirty-one consecutive patients were analyzed (50375 compressions, on average 1625 per patient). Of all compressions 2% were <80/min, 63% between 80-120/min and 35% >120/min. Mean compression depth for rates 80-120/min was 4.5 cm (SD=1) compared to 3.5 cm (SD=1) for compressions >120/min (P<0.001; see Figure). In 20 out of 31 (64%) patients a statistically significant lower depth was observed for rates >120/min compared to rates 80-120/min, in 10 out of 31 (32%) this difference was also clinically significant. There was no difference between the mean depth of compressions <80/min and the mean depth of compressions 80-120/min. Conclusions : Compression rates >120/min were associated with a lower compression depth. The observation that compression depth is lower with increased compression rates underscores the importance of feedback on rate during CPR. Reference Nolan JP, Hazinski MF, Billi JE, Boettiger BW, et al. Executive Summary 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2010; 81S: e1-e25.
Please use this url to cite or link to this publication:
author
organization
year
type
conference
publication status
published
subject
in
EUROPEAN JOURNAL OF ANAESTHESIOLOGY
Eur. J. Anaesth.
volume
28
issue
suppl. 48
pages
5 - 5
conference name
Euroanaesthesia 2011
conference location
Amsterdam, The Netherlands
conference start
2011-06-11
conference end
2011-06-14
JCR category
ANESTHESIOLOGY
JCR impact factor
2.231 (2011)
JCR rank
12/28 (2011)
JCR quartile
2 (2011)
ISSN
0265-0215
language
English
UGent publication?
yes
classification
C3
id
1988616
handle
http://hdl.handle.net/1854/LU-1988616
date created
2012-01-17 09:25:48
date last changed
2012-09-05 09:06:23
@inproceedings{1988616,
  abstract     = {Background and goal of study: In the latest Consensus on Science and Treatment Recommendations on Cardiopulmonary Resuscitation (ref), the relationship between compression rate and compression depth is considered to be a knowledge gap.  In order to characterize this relationship, we performed an observational study in pre-hospital cardiac arrest patients.
Materials and methods : In patients undergoing out-of-hospital cardiopulmonary resuscitation by health care professionals, chest compression rate and depth were recorded using an accelerometer (E-series monitor-defibrillator, Zoll, USA). The monitor provided real-time corrective feedback for compression rates {\textlangle}80/min and for depth {\textlangle}4 cm. Compression depth was analyzed for rates {\textlangle}80/min, 80-120/min and {\textrangle}120/min. A difference in compression depth \ensuremath{\geq}5 mm was considered potentially clinically significant. 
Results and discussion : Thirty-one consecutive patients were analyzed (50375 compressions, on average 1625 per patient). Of all compressions 2\% were {\textlangle}80/min, 63\% between 80-120/min and 35\% {\textrangle}120/min. Mean compression depth for rates 80-120/min was 4.5 cm (SD=1) compared to 3.5 cm (SD=1) for compressions {\textrangle}120/min (P{\textlangle}0.001; see Figure). In 20 out of 31 (64\%) patients a statistically significant lower depth was observed for rates  {\textrangle}120/min compared to rates 80-120/min, in 10 out of 31 (32\%) this difference was also clinically significant. There was no difference between the mean depth of compressions {\textlangle}80/min and the mean depth of compressions 80-120/min. 
Conclusions : Compression rates {\textrangle}120/min were associated with a lower compression depth. The observation that compression depth is lower with increased compression rates underscores the importance of feedback on rate during CPR. 
Reference
Nolan JP, Hazinski MF, Billi JE, Boettiger BW, et al. Executive Summary 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2010; 81S: e1-e25.},
  author       = {Kalmar, Alain and De Smet, Jeroen and Annaert, Emmanuel and De Regge, Melissa and Calle, Paul and Monsieurs, Koenraad},
  booktitle    = {EUROPEAN JOURNAL OF ANAESTHESIOLOGY},
  issn         = {0265-0215},
  language     = {eng},
  location     = {Amsterdam, The Netherlands},
  number       = {suppl. 48},
  pages        = {5--5},
  title        = {Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest},
  volume       = {28},
  year         = {2011},
}

Chicago
Kalmar, Alain, Jeroen De Smet, Emmanuel Annaert, Melissa De Regge, Paul Calle, and Koenraad Monsieurs. 2011. “Excessive Chest Compression Rate Is Associated with Insufficient Compression Depth in Out-of-hospital Cardic Arrest.” In European Journal of Anaesthesiology, 28:5–5.
APA
Kalmar, A., De Smet, J., Annaert, E., De Regge, M., Calle, P., & Monsieurs, K. (2011). Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest. EUROPEAN JOURNAL OF ANAESTHESIOLOGY (Vol. 28, pp. 5–5). Presented at the Euroanaesthesia 2011.
Vancouver
1.
Kalmar A, De Smet J, Annaert E, De Regge M, Calle P, Monsieurs K. Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest. EUROPEAN JOURNAL OF ANAESTHESIOLOGY. 2011. p. 5–5.
MLA
Kalmar, Alain, Jeroen De Smet, Emmanuel Annaert, et al. “Excessive Chest Compression Rate Is Associated with Insufficient Compression Depth in Out-of-hospital Cardic Arrest.” European Journal of Anaesthesiology. Vol. 28. 2011. 5–5. Print.