Extending resuscitation efforts by just 10 or 15 minutes could improve survival rates among patients who suffer cardiac arrest in the hospital.
The results also showed that patients who recovered after an extended CPR effort were no more likely to suffer brain damage than are patients revived after a shorter effort.
Each year in the United States, more than 200,000 hospitalized patients have a cardiac arrest. Less than half of these patients survive the arrest itself, and less than 20 percent survive to hospital discharge. Goldberger and his colleagues analyzed the records of 64,339 patients at 435 hospitals with the American Heart Association’s Get-with-the Guidelines-Resuscitation Registry, the largest sample available in the United States of patients who suffered a cardiac arrest during hospitalization. As expected, the duration of resuscitation before termination of efforts varied across hospitals.
What the researchers learned was that hospitals that routinely practiced the longest attempts at resuscitation, on average, had a 12 percent higher overall survival rate, compared to hospitals with the shortest CPR durations.
Most patients who were successfully resuscitated responded soon after the arrest. However, some patients required more time. The researchers found that, in 15 percent of the survivors, a pulse did not return until 30 minutes or more of resuscitation efforts had elapsed. Less than a quarter of those who died during a cardiac arrest were resuscitated for at least 30 minutes.
The results, Goldberger explained, do not apply to by-stander CPR or out-of-hospital medic resuscitation attempts. These situations are quite different from responding to cardiac arrests that occur in a hospital.