Background

Analyses of data recorded by monitor-defibrillators that measure CPR depth with different methods show significant relationships between the process and outcome of CPR. Our objective was to evaluate whether chest compression depth was significantly associated with outcome based on accelerometer-recordings obtained with monitor-defibrillators from a single manufacturer, and to assess whether an accelerometer-based analysis corroborated evidence-based practice guidelines on performance of CPR.

Methods and results

We included 5434 adult patients treated from seven US and Canadian cities between January 2007 and May 2015. These had mean (SD) age of 64.2 (17.2) years, mean compression depth of 45.9 (12.7) mm, ROSC sustained to ED arrival of 26%, and survival to hospital discharge of 8%. For survival to discharge, the adjusted odds ratios were 1.15 (95% CI, 0.86, 1.55) for cases within 2005 depth range (38–51 mm), and 1.17 (95% CI, 0.91, 1.50) for cases within 2010 depth range (>50 mm) compared to those with an average depth of <38 mm. The adjusted odds ratio of survival was 1.33 (95% CI, 1.01, 1.75) for cases within 2015 depth range (50 to 60 mm) for at least 60% of minutes.

Conclusions

This analysis of patients with OHCA demonstrated that increased chest compression depth measured by accelerometer is associated with better survival. It confirms that current evidence-based recommendations to compress within 50–60 mm are likely associated with greater survival than compressing to another depth.

中文翻译：

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加速计测量的按压深度与院外心脏骤停患者的结果

背景

对使用不同方法测量 CPR 深度的监护除颤器记录的数据进行分析，结果表明 CPR 的过程和结果之间存在显着关系。我们的目标是评估胸外按​​压深度是否与基于来自单一制造商的监护除颤器的加速度计记录的结果显着相关，并评估基于加速度计的分析是否证实了关于 CPR 性能的循证实践指南。

方法和结果

我们纳入了 2007 年 1 月至 2015 年 5 月期间从美国和加拿大的七个城市接受治疗的 5434 名成年患者。这些患者的平均 (SD) 年龄为 64.2 (17.2) 岁，平均压迫深度为 45.9 (12.7) mm，ROSC 持续至 ED 到达时间为 26 %，出院存活率为 8%。对于出院存活率，2005 年深度范围（38-51 毫米）内病例的调整比值比为 1.15（95% CI，0.86，1.55），2010 年深度范围内病例的调整比值比为 1.17（95% CI，0.91，1.50） (>50 mm) 与平均深度 <38 mm 的那些相比。对于 2015 年深度范围（50 至 60 毫米）内至少 60% 分钟的病例，调整后的生存比值比为 1.33（95% CI，1.01，1.75）。

结论

这项对 OHCA 患者的分析表明，通过加速计测量的胸外按压深度增加与更好的生存率相关。它证实了当前的循证建议在 50-60 毫米内压缩比压缩到另一个深度可能与更高的存活率相关。