Minimizing pauses in chest compressions during CPR has a significant positive impact on outcomes related to chest compression fraction (CCF) and patient survival, particularly in pediatric in-hospital cardiac arrest (IHCA).
Impact of Minimizing Pauses on CCF and Outcomes
- Chest Compression Fraction (CCF) refers to the proportion of time during CPR that chest compressions are actively performed. Minimizing pauses increases CCF, which is generally considered beneficial for maintaining perfusion during resuscitation
- However, recent studies indicate that while longer pauses in chest compressions are strongly associated with worse survival outcomes and lower chances of return of spontaneous circulation (ROSC), CCF itself was not consistently associated with survival or neurological outcomes in pediatric IHCA
- Specifically, each 5-second increase in the longest chest compression pause duration was associated with approximately a 3% lower relative chance of survival with favorable neurological outcome and survival to hospital discharge
- Pauses longer than 10 seconds were significantly linked to lower probability of ROSC, emphasizing the importance of keeping pauses short, ideally under 10 seconds as recommended by the American Heart Association (AHA)
- The negative impact of pauses is thought to arise because any interruption reduces coronary and cerebral perfusion pressure, which is critical for successful resuscitation
Summary
- Minimizing pauses in chest compressions improves the effective delivery of CPR by increasing CCF.
- Shorter pauses (<10 seconds) correlate with better ROSC rates and survival outcomes, especially in pediatric cardiac arrest.
- The duration of pauses has a more direct impact on survival and neurological outcomes than overall CCF alone.
- These findings support guidelines emphasizing minimizing interruptions during CPR to improve patient outcomes
In conclusion, reducing the length and frequency of pauses during chest compressions enhances the quality of CPR and is associated with improved survival and neurological outcomes, even if CCF itself is not always directly linked to these outcomes.
