Advanced search

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

Author
Organization
Abstract
Introduction : In the 2010 Guidelines on Cardiopulmonary Resuscitation the relationship between compression rate and depth is considered to be a knowledge gap. In order to characterise this relationship, we performed an observational study in out-of-hospital cardiac arrest patients. We hypothesized that faster chest compressions are associated with decreased depth. Materials and methods : In patients undergoing out-of-hospital cardiopulmonary resuscitation according to 2005 Guidelines, chest compression rate and depth were recorded using an accelerometer on a Zoll E-series monitor-defibrillator providing feedback for compressions <4 cm deep and <80/min. Compression depth was compared for rates <80/min, 80-120/min and >120/min. Multilevel models with repeated measurements of compression depth and rate, nested within patients, were used with depth as a continuous and as a categorical variable. A difference in depth ≥0.5 cm was considered clinically significant. Results are reported as means and standard error. Results and discussion : One hundred and thirty-three consecutive patients were analysed (213409 compressions). Of all compressions 2% were <80/min, 62% between 80-120/min and 36% >120/min, 36 % were <4 cm deep, 45% between 4 and 5 cm, 19% >5cm. Compression depth for rates 80-120/min was 4.6 (±0.003) cm compared to 3.9 (±0.003) cm for compressions >120/min (mean difference 0.7 cm, P<0.001). In 77 out of 133 (58 %) patients a statistically significant lower depth was observed for rates >120/min compared to rates 80-120/min, in 40 out of 133 (30%) this difference was also clinically significant. Moreover, the multilevel models showed that the deepest compression occurred at a rate of 64/min, with progressively lower depths at higher rates. Age and sex of the patient had no additional effect on depth. Conclusions : This study showed an association between higher compression rates and lower compression depths. To avoid superficial compressions, feedback devices should alert rescuers when compression rates become excessively high.
Keywords
cardiac arrest, compression rate, compression depth

Citation

Please use this url to cite or link to this publication:

Chicago
Monsieurs, Koenraad, Melissa De Regge, Kristof Vansteelandt, Jeroen Desmet, Emmanuel Annaert, SABINE LEMOYNE, Alain Kalmar, and Paul Calle. 2012. “Excessive Chest Compression Rate Is Associated with Insufficient Compression Depth in Out-of-hospital Cardic Arrest.” In Acta Clinica Belgica. Vol. 67.
APA
Monsieurs, K., De Regge, M., Vansteelandt, K., Desmet, J., Annaert, E., LEMOYNE, S., Kalmar, A., et al. (2012). Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest. ACTA CLINICA BELGICA (Vol. 67). Presented at the 2012 Symposium of the Belgian Society for Disaster and Emergency Medicine (BESEDIM).
Vancouver
1.
Monsieurs K, De Regge M, Vansteelandt K, Desmet J, Annaert E, LEMOYNE S, et al. Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest. ACTA CLINICA BELGICA. 2012.
MLA
Monsieurs, Koenraad, Melissa De Regge, Kristof Vansteelandt, et al. “Excessive Chest Compression Rate Is Associated with Insufficient Compression Depth in Out-of-hospital Cardic Arrest.” Acta Clinica Belgica. Vol. 67. 2012. Print.
@inproceedings{1988708,
  abstract     = {Introduction : In the 2010 Guidelines on Cardiopulmonary Resuscitation the relationship between compression rate and depth is considered to be a knowledge gap.  In order to characterise this relationship, we performed an observational study in out-of-hospital cardiac arrest patients. We hypothesized that faster chest compressions are associated with decreased depth.
Materials and methods : In patients undergoing out-of-hospital cardiopulmonary resuscitation according to 2005 Guidelines, chest compression rate and depth were recorded using an accelerometer on a Zoll E-series monitor-defibrillator providing feedback for compressions {\textlangle}4 cm deep and {\textlangle}80/min. Compression depth was compared for rates {\textlangle}80/min, 80-120/min and {\textrangle}120/min. Multilevel models with repeated measurements of compression depth and rate, nested within patients, were used with depth as a continuous and as a categorical variable. A difference in depth \ensuremath{\geq}0.5 cm was considered clinically significant. Results are reported as means and standard error.
Results and discussion : One hundred and thirty-three consecutive patients were analysed (213409 compressions). Of all compressions 2\% were {\textlangle}80/min, 62\% between 80-120/min and 36\% {\textrangle}120/min, 36 \% were {\textlangle}4 cm deep, 45\% between 4 and 5 cm, 19\% {\textrangle}5cm. Compression depth for rates 80-120/min was 4.6 ({\textpm}0.003) cm compared to 3.9 ({\textpm}0.003) cm for compressions {\textrangle}120/min (mean difference 0.7 cm, P{\textlangle}0.001). In 77 out of 133 (58 \%) patients a statistically significant lower depth was observed for rates {\textrangle}120/min compared to rates 80-120/min, in 40 out of 133 (30\%) this difference was also clinically significant. Moreover, the multilevel models showed that the deepest compression occurred at a rate of 64/min, with progressively lower depths at higher rates. Age and sex of the patient had no additional effect on depth.
Conclusions : This study showed an association between higher compression rates and lower compression depths. To avoid superficial compressions, feedback devices should alert rescuers when compression rates become excessively high.},
  author       = {Monsieurs, Koenraad and De Regge, Melissa and Vansteelandt, Kristof and Desmet, Jeroen  and Annaert, Emmanuel and LEMOYNE, SABINE and Kalmar, Alain and Calle, Paul},
  booktitle    = {ACTA CLINICA BELGICA},
  issn         = {0001-5512},
  keyword      = {cardiac arrest,compression rate,compression depth},
  language     = {eng},
  location     = {Brussels, Belgium},
  title        = {Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest},
  volume       = {67},
  year         = {2012},
}