A new study has found that keeping resuscitation efforts going for longer could improve brain function in survivors. The sooner that CPR is started after someone’s heart stops, the better. That we can all agree on. Now, Japanese researchers report that continuing CPR for a half-hour or more may help victims survive with good brain function – even after a full 38 minutes – according to a study presented at the American Heart Association’s Scientific Sessions 2013.
But how did the researchers come to these conclusions?
They reviewed data on more than 280,000 people who had experienced cardiac arrest outside a hospital. When the patients’ hearts stopped, there had been at least one other person nearby. Next, they narrowed that large group down to those whose hearts started beating on their own after resuscitation. Doctors call this “return of spontaneous circulation.” This group included almost 32,000 people.
When the researchers examined those patients 30 days after their cardiac arrest, they found that just more than 27 percent had good brain function. Those who had good brain function averaged 13 minutes from the moment their heart stopped until their heart started beating again on its own. Those with less favorable outcomes averaged almost 22 minutes of resuscitation efforts before their hearts started beating again. Some people even had favorable outcomes after as long as 38 minutes of resuscitation efforts. (via)
After adjusting for other factors that can affect neurological outcomes, researchers found that the odds of surviving an out-of-hospital cardiac arrest without severe brain damage dropped 5 percent for every 60 seconds that passed before spontaneous circulation was restored.
Based on the relationship between favorable brain outcomes and the time from collapse to a return of spontaneous circulation, the researchers calculated that CPR lasting 38 minutes or more was advisable.
“It may be appropriate to continue CPR if the return of spontaneous circulation occurs for any period of time,” said Ken Nagao, M.D., Ph.D., professor and director-in-chief of the Department of Cardiology, CPR and Emergency Cardiovascular Care at Surugadai Nihon University Hospital in Tokyo.
This research hasn’t been officially published in a peer-reviewed journal yet, but the findings are encouraging.
Comments
Great post. I teach a lot of CPR classes, and people always ask me how long they should do CPR. I give them a few criteria of when they can stop, but this sets a goal they should reach for.
Really? Because my dad received cpr for TWENTY minutes last week when he went into cardiac arrest. Since he was already at an ER (and already WITH THE DOCTOR) for breathing trouble, he received cpr RIGHT AWAY. Since his brain was without oxygen for so long (remember, they performed CPR for 20 minutes), the only part of his brain that was NOT severely damaged was his brain stem. So I think you should reevaluate the accuracy of your sources.
I’m sorry that your experience wasn’t better. I can’t claim to know what you’re going through, and what the causes of the cardiac arrest were that lead to this result. Sometimes there are complications that change the potential outcome and it is out of our control. I recommend watching this video for more information.
The brain stops receiving oxygen after about 4 minutes. After a few more minutes you start to get brain hypoxia (brain damage due to not getting enough oxygen to your brain). Just a few minutes after that, your brain hypoxia turns into anoxia – which is obviously much worse. So I don’t see how performing CPR for 30 minutes is at all effective. People usually stop performing CPR after about 10 minutes because, after that, there’s already too much irreversible brain damage – which essentially leaves and individual brain dead.
BTW, my dad passed away (the day after I posted my original comment) due to severe anoxic brain damage (because of not getting any oxygen to his brain for 16 minutes).
Dear Sarah my deepest condolences .I lost my mother in hospital recently by massive PE,,they did simply do no cpr :young doctor found her to old and with false statistics .There is a difference between in- hospital patients and out- of -hospital patient in good outcome with cpr..
I think that t
hose doctors were incompetent.Did they gave thrombolysis to remove the clot,oxigen and other things?The compressions must be deep all the time,they must be enough people to take over every 2 minutes.
Sarah I’m so sorry, I’m a nurse so I’ve preformed CPR it doesn’t always work regardless of how long you perform it. My husband recently went into the hospital because he was having difficulty breathing, they even called me to intubate him, before he went to the hospital I did everything to keep him calm including medication and nebulizer treatments but I noticed his feet and hand were a little swollen so I was worried about CHF he never had heart problems. An hour after the first call I was told he had a massive heart attack but they got him back after 30 minutes but it didn’t look good, I’ve often wondered why they would do CPR for 30 minutes I’m well aware of what happens when the brain goes without oxygen, they then took my husband to the Cath lab, I can’t say I don’t appreciate everything they tried to do, because of COVID I couldn’t be there. He had another heart attack and he passed, but even if he were just here its better than what I’m still going through. I miss him every day but CPR works for most, I feel awful for your father. Gbu
I’m so sorry for what you and your family are going through. Keep in mind, everyone is different. My son, who was seven at the time, suffered cardiac arrest and was resuscitated for 30 minutes. His brain function is shockingly good for what he experienced. He has damage to his frontal and parietal lobes, and is receiving help to overcome those issues. The article doesn’t say that outcomes are good for everyone, just that chances increase with prolonged efforts.
Sarah you are talking about stuff that apperently you don’t know much about, depending on the type of Heart Attack CPR can be completely useless.
For example if someone has a heart attack due to a major blockage in the heart or collapsed valve compressions will do little nothing to help circulate blood because the blood can’t go anywhere…
However if someone’s heart stops due to something like electrical shock and there is no obstruction then CPR can be quite effective at keeping someone alive and preventing brain damage.
I am sorry for your loss, but your specific case does not overshadow 10s of thousands reviewed in this study.
It could be a blockage in the heart or from a massive PE in the lungs.Both are reversibel.One must just as soon as possible after cpr give oxigen and thrombolysis to remove the clot.With PE cpr:60 to 90 minutes and then there is a good outcome,certainly in hospital patients.
I think the point she isn’t getting is that performing cpr is what gets oxygen to the brain until there is spontaneous cardiac function .Unless there are certain circumstances preventing the oxygen from being able to reach the brain.
Not true. My son came home to find his girlfriend not breathing no heartbeat called 911 and started compressions. Took paramedics 5 minutes to get there they worked on her for 12 1/2 minutes gave up on the CPR gave her a shot in the heart and she is walking talking speaking and remembers everything that has happened in her life.
I thank God for medical science and that we are able to save so many lives today. Am a nurse and worked in the ICU for years. Was in multiple codes some made it some didn’t. With nurses and doctors right at their sides. Each scenario is different you have to look at the entire patient history and underlying causes. I understand its heart breaking to lose a love one had to comfort many trust me there are no words. But we put to much trust in science am a firm believer that life and death lies in the hands of the almighty creator. It t looks like we are in control but I beg the differ…
If anything ever happened to stop my heart, a possibility with 3 close family members deceased and all affected by one heart problem or another, I want them to work on me for at least 45 minutes
I wonder if anyone of you could shed light on an episode that occured to my elderly mother a few years ago, while she was an outpatient at my local hospital. She was extremely weak because of a therapy she was following on a day hospital basis and collapsed while being fitted with a IV cannula. At that point (we later discovered from her hospital records) she had cardiac arrest and was given CPR by the ward doctor. She very quickly recovered but was kept in hospital for two days, to check on her I suppose. The fact is that I discovered that she had been resuscitated only because I noticed a massive bruise on her chest and asked a nurse how she’d got that. I then made enquiries with a (different) doctor but he said that there never was cardiac arrest, that she had been given CPR as a precautionary measure. Is it possible? We had the impression the doctors didn’t want us to know about the cardiac arrest, maybe they were afraid of litigation. It seems to me that no one would perform CPR if the heart is still beating.
Stephanie- People do CPR all of the time for people who aren’t breathing, but still have a pulse to also help prevent Cardiac Arrest, it doesn’t mean they went into cardiac arrest. I don’t understand why you would think anyone would think it’s appropriate to sue the doctor who saved your mother’s life. Are you implying that if your mother’s heart stopped that it didn’t go into cardiac arrest by itself? That it went into arrest because of something they had done? There is also a difference if someone was worried that she did go into cardiac arrest but then they realized she did not. The Emergency Room functions much differently.
She didn’t imply she was going to sue them. She was guessing about why she was getting conflicting information from the doctor and nurse
I am 50 years old and just survived 45 mins of CPR applied by paramedics as soon as I went into arrest. At ROSC I was in a coma for 4 days, but I have no loss of brain function. It was congenital VF arrest caused by myocarditis. I am otherwise healthy. One of the paramedics came to see me afterwards and was speechless and emotional.
Phillip, you have given me hope. My husband went into VF arrest 3 days ago.He received 25 minutes and 2 shocks. He is breathing on own but heavily sedated for assisted intubation.. So they can not assess brain function yet. As they try to wean him off sedation he becomes agitated.They performed targeted temperature therapy too. He opens eyes and moves all extremities and has gag reflex. He is 53 yrs old. Dr feel he needs to clear a little more before assessing brain function so with your story I’m hopeful. I am so happy you are without any side effects. Stay safe and healthy.
CPR and Targeted Temperture therapy my husband has made a full recovery. With a St Jude ICD in place. No anoxic brain or cognitive deficits. We have educated all our family on proper CPR technique and continue to spread education.
Well my father went into cardiac arrest under general anesthesia 15 min. into a TEE procedure. He was given CPR for 17 mins. before ROSC was established. He had several health issues including End Stage Renal Failure. But they continued CPR anyway, the outcome is not good, as we now have to start to prepare for Hospice. I wonder why they continued to put him through all of the resuscitation. Then TTM and CT’s and all the other things that they need to do before they to perform only to come before they officially say he has suffered severe brain damage. I don’t understand why it was continued and the outcome would be is for him to die again.
I thank God for medical science and that we are able to save so many lives today. Am a nurse and worked in the ICU for years. Was in multiple codes some made it some didn’t. With nurses and doctors right at their sides. Each scenario is different you have to look at the entire patient history and underlying causes. I understand its heart breaking to lose a love one had to comfort many trust me there are no words. But we put to much trust in science am a firm believer that life and death lies in the hands of the almighty creator. It t looks like we are in control but I beg the differ…