Since 2008, the American Heart Assn. has recommended a “hands only” approach to CPR,
emphasizing the importance of performing rapid chest compressions on victims of
sudden cardiac arrest. The group decided to nix the mouth-to-mouth portion of
cardiopulmonary resuscitation in part because studies show that it doesn’t improve overall survival,
and in part to increase the odds that a bystander would perform any kind of CPR
at all.
But a new study finds that the old-fashioned version of
CPR is more effective at resuscitating children in cardiac arrest.
Japanese researchers examined the medical records of 5,170
minors (ages 17 and younger) who were treated by emergency medical personnel
for an out-of-hospital cardiac arrest in the years 2005, 2006 and 2007.
Unfortunately, only 9% of those children survived, and even fewer— 3%--had a
“favorable neurological outcome.” But the ones who got CPR from a bystander
stood a much better chance of preserving their neurological function than those
who didn’t—4.5% vs. 1.9%, according to a report being published online
Wednesday by the journal Lancet.
The researchers also found that conventional CPR was more
likely to result in a “favorable neurological outcome” than compression-only
CPR. In their analysis, 7.2% of children given chest compressions and mouth-to-mouth had a good outcome,
compared with 1.6% of kids who got compressions only.
In a commentary accompanying the study, Spanish
researchers say the reason is probably that most cases of sudden cardiac arrest
in children— 71% in the Japanese study and more than 90% in other studies—are
probably caused by non-cardiac events. (Only about a third of cases in adults
are thought to have non-cardiac origins.) In such cases, mouth-to-mouth
resuscitation is helpful. When cardiac arrest has a cardiac cause, either type
of CPR works equally well.
They conclude that bystanders should continue to provide
traditional CPR to children in cardiac arrest.
SOURCE: Karen Kaplan, LA Times