Chest Compression Fraction Alone Does Not Adequately Measure Cardiopulmonary Resuscitation Quality in Out-of-Hospital Cardiac Arrest

• Published in: The Journal of emergency medicine Vol. 62; no. 3; pp. e35 - e43
• Main Authors: Loza-Gomez, Angelica, Johnson, Megan, Newby, Marianne, LeGassick, Todd, Larmon, Baxter
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2022
• Subjects: Adult; Cardiopulmonary Resuscitation; compression fraction; Humans; out-of-hospital cardiac arrest; Out-of-Hospital Cardiac Arrest - therapy; prehospital care; Pressure; Prospective Studies; Thorax; cardiopulmonary resuscitation; compression fraction; prehospital care; out-of-hospital cardiac arrest
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2021.10.030

High-quality cardiopulmonary resuscitation in out-of-hospital cardiac arrest is important for increased survival and improved neurological outcome. Chest compression fraction measures the proportion of time chest compressions are given during a cardiac arrest resuscitation. Chest compression fraction has not been compared with the quality of chest compressions delivered at the recommended rate and depth of 100–120/min and 2.0–2.4 inches, respectively. We evaluate whether chest compression fraction correlates with compressions at a target rate of 100–120/min and depth of 2.0–2.4 inches in chest diameter. A prospective, observational study design was used to compare chest compression fraction to compressions in target in out-of-hospital cardiac arrest patients in a prehospital urban setting. We include all adult, non-traumatic out-of-hospital cardiac arrest patients with a resuscitation attempt during January 1, 2019 through September 30, 2019, for a total of 9 months. Spearman's rank correlation was used to determine correlation between compression fraction and compressions in target. A total of 120 out-of-hospital cardiac arrest cases were included in the study. We found a high chest compression fraction median of 83% (interquartile range 72–90%), but a low compression in target median of 13% (interquartile range 5–29%). There was no significant correlation between chest compression fraction and compressions in target when analyzed linearly (Spearman's Rho = 0.165, p = 0.072). No difference was found when dichotomizing chest compression fraction into high and low variables in comparison with compressions in target (14% vs. 10%, p = 0.119). Chest compression fraction is not associated with compressions in target for rate and depth for out-of-hospital cardiac arrest cardiopulmonary resuscitation.