Posted by Bob Trenkamp on 01/27/2012

The NIH has launched two multicenter clinical trials that will evaluate treatments for sudden cardiac arrest that occurs out of the hospital.

The CCC trial will compare survival with hospital discharge rates for two CPR approaches — continuous chest compressions combined with pause-free rescue breathing vs. standard CPR — delivered by paramedics and firefighters to those experiencing cardiac arrest. Trained emergency personnel will give all participants in the CCC trial three cycles of CPR followed by heart rhythm analysis and, if needed, defibrillation.

There have been two trials in Scandanavia that showed 30%-40% improvements in outcome with compression-only CPR. There was a study in Japan that showed that, for a specific class of heart disease, compression-only CPR was not as good as 30 & 2 CPR.

What will really be interesting is to see whether the promotion of compression-only CPR will persuade more people to take action at the scene of a cardiac arrest. If compression-only CPR increases the number of bystanders who take action, it the CCC trial will conclude that continuous-compression CPR is a really good thing.

A related, recent study showed that cardiac arrest victims who were intubated - the traditional gold standard for control of the airway - fared far worst than victims who were not intubated. Apparently, it's all about minimizing interruptions during chest compressions, at least in the first 5-10 minutes.