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Trial of Continuous or Interrupted Chest Compressions during CPR

Open access
Nichol, Graham, Leroux, Brian, Wang, Henry, Callaway, Clifton W., Sopko, George, Weisfeldt, Myron, Stiell, Ian, Morrison, Laurie J., Aufderheide, Tom P., Cheskes, Sheldon, Christenson, Jim, Kudenchuk, Peter, Vaillancourt, Christian, Rea, Thomas D., Idris, Ahamed H., Colella, Riccardo, Isaacs, Marshal, Straight, Ron, Stephens, Shannon, Richardson, Joe, Condle, Joe, Schmicker, Robert H., Egan, Debra, May, Susanne, Ornato, Joseph P.·2015·New England Journal of Medicine

Abstract

BACKGROUND: During cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiac arrest, the interruption of manual chest compressions for rescue breathing reduces blood flow and possibly survival. We assessed whether outcomes after continuous compressions with positive-pressure ventilation differed from those after compressions that were interrupted for ventilations at a ratio of 30 compressions to two ventilations. METHODS: This cluster-randomized trial with crossover included 114 emergency medical service (EMS) agencies. Adults with non-trauma-related cardiac arrest who were treated by EMS providers received continuous chest compressions (intervention group) or interrupted chest compressions (control group). The primary outcome was the rate of survival to hospital discharge. Secondary outcomes included the modified Rankin scale score (on a scale from 0 to 6, with a score of ≤3 indicating favorable neurologic function). CPR process was measured to assess compliance. RESULTS: Of 23,711 patients included in the primary analysis, 12,653 were assigned to the intervention group and 11,058 to the control group. A total of 1129 of 12,613 patients with available data (9.0%) in the intervention group and 1072 of 11,035 with available data (9.7%) in the control group survived until discharge (difference, -0.7 percentage points; 95% confidence interval [CI], -1.5 to 0.1; P=0.07); 7.0% of the patients in the intervention group and 7.7% of those in the control group survived with favorable neurologic function at discharge (difference, -0.6 percentage points; 95% CI, -1.4 to 0.1, P=0.09). Hospital-free survival was significantly shorter in the intervention group than in the control group (mean difference, -0.2 days; 95% CI, -0.3 to -0.1; P=0.004). CONCLUSIONS: In patients with out-of-hospital cardiac arrest, continuous chest compressions during CPR performed by EMS providers did not result in significantly higher rates of survival or favorable neurologic function than did interrupted chest compressions. (Funded by the National Heart, Lung, and Blood Institute and others; ROC CCC ClinicalTrials.gov number, NCT01372748.).

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Metadata

Authors
Nichol, G., Leroux, B., Wang, H., Callaway, C. W., Sopko, G., Weisfeldt, M., Stiell, I., Morrison, L. J., Aufderheide, T. P., Cheskes, S., Christenson, J., Kudenchuk, P., Vaillancourt, C., Rea, T. D., Idris, A. H., Colella, R., Isaacs, M., Straight, R., Stephens, S., Richardson, J., Condle, J., Schmicker, R. H., Egan, D., May, S., & Ornato, J. P.
Venue
New England Journal of Medicine
Published
2015-12-03
Volume
373
Issue
23
Pages
2203-2214
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2178502634
Cited by
299
References
32
FWCI
35.99
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Trial of Continuous or Interrupted Chest Compressions during CPR. https://app.cochat.ai/papers/10.1056/nejmoa1509139
The paper
Nichol, G., Leroux, B., Wang, H., Callaway, C. W., Sopko, G., Weisfeldt, M., Stiell, I., Morrison, L. J., Aufderheide, T. P., Cheskes, S., Christenson, J., Kudenchuk, P., Vaillancourt, C., Rea, T. D., Idris, A. H., Colella, R., Isaacs, M., Straight, R., Stephens, S., . . . Ornato, J. P. (2015). Trial of Continuous or Interrupted Chest Compressions during CPR. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1509139

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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