Bystander CPR Not Only Improves Survival But Reduces Brain Damage Interview with:

Kristian Kragholm, MD, PhD Departments of Cardiology and Epidemiology/Biostatistics, Aalborg University Hospital, Aalborg, DK

Dr. Kragholm

Kristian Kragholm, MD, PhD
Departments of Cardiology and Epidemiology/Biostatistics,
Aalborg University Hospital,
Aalborg, DK What is the background for this study? What are the main findings?

Response: It is well known that early help from bystanders including cardiopulmonary resuscitation (CPR) before arrival of the emergency medical services can increase chances of 30-day survival by three to four times compared to situations where no bystander resuscitation was initiated.

The main and novel finding of our study is that bystander interventions, in addition to increasing survival, also lowers the risk of damage to the brain and nursing home admission in 30-day survivors during the first year following out-of-hospital cardiac arrest. What should readers take away from your report?

Response: Among patients who survived to day 30, the one-year risk of brain damage was 20% and the one-year risk of death was 15% if bystanders did not start resuscitation. These numbers were 12% and 8% if bystanders initiated CPR. The risk of brain damage was 8% and the risk of death was 2% if bystanders defibrillated the patient using an automated external defibrillator (AED).

Our study findings underscore the importance of learning about how to recognize cardiac arrest, how to do chest compressions and how to employ an AED, if available. Also, our study stresses the importance of optimal prehospital infrastructures, where AEDs are widely disseminated and accessible. What recommendations do you have for future research as a result of this study?

Response: Our study findings support every effort to educate the public in CPR and use of AEDs, and to make AEDs more accessible to the public. Despite our very uplifting results, there remains room for improvement. There is potential for further increases in bystanders’ willingness to start compressions and public use of AEDs. There is a need for future studies to improve these early efforts through assessment of geographical and community differences in these efforts. There is also a need for interventions where volunteers sign up to receive and respond to a text message from emergency dispatch centers in cases of cardiac arrest, where a volunteer can find the nearest AED and bring this to the person who has cardiac arrest, start chest compressions and defibrillate the person.

Disclosures: The Danish Cardiac Arrest Registry is funded by the TrygFonden Foundation. My research is supported by the Danish Heart Association and The Laerdal Foundation. Outside this work, I have received speaker’s honoraria from Novartis. Thank you for your contribution to the community.

Bystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest
Kristian Kragholm, M.D., Ph.D., Mads Wissenberg, M.D., Ph.D., Rikke N. Mortensen, M.Sc., Steen M. Hansen, M.D., Carolina Malta Hansen, M.D., Ph.D., Kristinn Thorsteinsson, M.D., Ph.D., Shahzleen Rajan, M.D., Freddy Lippert, M.D., Fredrik Folke, M.D., Ph.D., Gunnar Gislason, M.D., Ph.D., Lars Køber, M.D., D.Sc., Kirsten Fonager, M.D., Ph.D., Svend E. Jensen, M.D., Ph.D., Thomas A. Gerds, Ph.D., Christian Torp-Pedersen, M.D., D.Sc., and Bodil S. Rasmussen, M.D., Ph.D.
N Engl J Med 2017; 376:1737-1747
May 4, 2017 DOI: 10.1056/NEJMoa1601891

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Last Updated on May 5, 2017 by Marie Benz MD FAAD