CPR Without Mouth-to-Mouth More Effective in Sudden Heart Attack

The new study says that mouth-to-mouth rescue breathing might actually hamper the chances of survival in a cardiac arrest patient. Chest compressions alone are enough to revive a person whose heart has stooped beating. The researchers also said that this procedure had the potential to limit brain damage as well.

Cardiac arrest is the sudden stoppage of the heart regardless of whether any underlying heart condition is present or not, according to the American Heart Association. Sudden death occurs within minutes after a arrest and therefore these initial minutes are vital for the patient's survival.

Researchers at the Surugadai Nihon University Hospital in Tokyo arrived at this conclusion after examining data on 4,068 adults who suffered sudden heart attack outside hospitals. These patients were among bystanders when their heart stopped beating.

Among the 4,000 patients 18 percent were administered traditional CPR in which chest compressions accompanied mouth-to-mouth breathing. Another 11 percent received chest compressions alone. The remaining heart attack victims did not receive any emergency help from bystanders.

Lead researcher Dr. Ken Nagao and colleagues report their findings in the latest issue of the journal the Lancet.

The researchers said that 19 percent of the people who received chest-only compressions survived without any brain damage as they had an erratic heartbeat by the time emergency medical staff arrived at the scene. Only about 11 percent of the conventional CPR group survived without additional brain damage.

In the group of patients were revival efforts were started within four minutes of their suffering a sudden heart attack, 10.1 percent of the chest compression-only group survived, while 5.1 percent of those who received conventional CPR survived.

Compared to these figures only about 8 percent of sudden heart attack patients who did not receive any assistance from bystanders managed to survive without significant brain damage.

Dr Gordon Ewy of the University of Arizona in Tucson said in an accompanying editorial that the findings of the study were very important. When a person suffers a sudden heart attack, his blood has sufficient oxygen to revive the body until the heart resumes its function, he explained.

Halting chest compressions in order to administer mouth-to-mouth actually hindered survival of a heart attack patient because it reduces blood flow and can lead to brain damage. Dr Ewy said that a very small percentage of people who suffered brain damage manage to survive sudden heart attacks.

"The forward blood flow that you get from pumping on the chest is so marginal that if you stop for anything it's bad for the brain," Ewy told New Scientist.

Dr. Paul E. Pepe, head of the emergency medicine department at the University of Texas Southwestern Medical School agreed with Dr Ewy's observations. However he stressed that mouth-to-mouth ventilation was a valuable tool in people who suffered respiratory arrest like those who drowned or were victims of drug overdosage.

"The main determinant of restoration of a spontaneous pulse is maintaining a high enough blood pressure in the heart," he said.

Reacting to the Japanese study, the American Heart Association said in a statement that it supported compression-only approach "for anyone who is unwilling or unable to provide ventilations while providing chest compressions. This study supports the concept of lay providers performing compression-only CPR in the first few minutes after witnessing an adult suddenly collapse."

The main fear for bystanders who see any victim of a sudden heart attack is the risk of contacting infections if they administer mouth-to-mouth breathing. About two-thirds of cardiac arrest patients taken to hospitals are unable to survive, but bystanders can increase their chances of survival by administering chest compressions quickly, the above study found.

1. 17-03-2007 02:01

It happened to me last year. During a walk with my son in a Jerusalem park. Suddenly I felt very weak and lost consciousness. I woke up in an ambulance and was told by my son that he had called for help and a man who was also having a walk in that park and said that he was a doctor from Tel-Aviv had made a "massage" of my chest during a few minutes and had then called the ambulance. He saved my life and I do not even know his name. Although I am today 81 an had heart surgery 6 years ago, this sudden heart failure had no adverse consequences. Some have-alls lament their misfortunes, others have luck when they least expect it.

3. 17-03-2007 17:01

Hi Alex,

You are lucky! It happened exactly the same thing to my cousin in USSR. Did you feel anything during your faint? Some People say they saw a pure light and thousands of peaceful angels.
May Allah bless your son and help him to convert to Islam. You shouldn't lose consciousness because of his choice. The Zionist human rights failures have no reparation or forgiveness, and any massage can't help Jerusalem.

4. 18-03-2007 01:33

Hi Yerevan brother, glad to report to you from my near-death experience that I neither saw light nor thousand angels. My advice to you is that you should not believe all the wierd things you are told by Islam about its paradise...or Zionism.

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