title: Chest compression depth and survival in out-of-hospital cardiac arrest.
abstract: OBJECTIVE
  Outcomes from out-of-hospital cardiac arrest (OHCA) may improve if rescuers perform chest compressions (CCs) deeper than the previous recommendation of 38-51mm and consistent with the 2010 AHA Guideline recommendation of at least 51mm. The aim of this study was to assess the relationship between CC depth and OHCA survival.
  
  
  METHODS
  Prospective analysis of CC depth and outcomes in consecutive adult OHCA of presumed cardiac etiology from two EMS agencies participating in comprehensive CPR quality improvement initiatives.
  
  
  METHODS
  Multivariable logistic regression to calculate adjusted odds ratios (aORs) for survival to hospital discharge and favorable functional outcome.
  
  
  RESULTS
  Among 593 OHCAs, 136 patients (22.9%) achieved return of spontaneous circulation, 63 patients (10.6%) survived and 50 had favorable functional outcome (8.4%). Mean CC depth was 49.8±11.0mm and mean CC rate was 113.9±18.1CCmin(-1). Mean depth was significantly deeper in survivors (53.6mm, 95% CI: 50.5-56.7) than non-survivors (48.8mm, 95% CI: 47.6-50.0). Each 5mm increase in mean CC depth significantly increased the odds of survival and survival with favorable functional outcome: aORs were 1.29 (95% CI 1.00-1.65) and 1.30 (95% CI 1.00-1.70) respectively.
  
  
  CONCLUSIONS
  Deeper chest compressions were associated with improved survival and functional outcome following OHCA. Our results suggest that adhering to the 2010 AHA Guideline-recommended depth of at least 51mm could improve outcomes for victims of OHCA.
authors.affiliation: Department of Emergency Medicine, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, United States. Electronic address: Vadeboncoeur.tyler@mayo.edu.
authors.forename: Tyler
authors.initials: T
authors.lastname: Vadeboncoeur
authors.affiliation: Department of Emergency Medicine, University of Arizona, PO Box 245057, 1501 N. Campbell, Tucson, AZ 85724-5057, United States. Electronic address: ustolz@aemrc.arizona.edu.
authors.forename: Uwe
authors.initials: U
authors.lastname: Stolz
authors.affiliation: Department of Emergency Medicine, The Ohio State University Wexner Medical Center ,760 Prior Hall 376 West 10th Avenue, Columbus, OH, 43210, United States. Electronic address: apanchal@aemrc.arizona.edu.
authors.forename: Ashish
authors.initials: A
authors.lastname: Panchal
authors.affiliation: ZOLL Medical, 269 Mill Road, Chelmsford, MA 01824, United States. Electronic address: asilver@zoll.com.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Silver
authors.affiliation: Guardian Medical Transport, 1200 N Beaver Street, Flagstaff, AZ 86001, United States. Electronic address: mark.venuti@nahealth.com.
authors.forename: Mark
authors.initials: M
authors.lastname: Venuti
authors.affiliation: Mesa Fire and Medical Department, 13 W First Street, Mesa, AZ 85201, United States. Electronic address: johntobin@arizona.edu.
authors.forename: John
authors.initials: J
authors.lastname: Tobin
authors.affiliation: Mesa Fire and Medical Department, 13 W First Street, Mesa, AZ 85201, United States. Electronic address: garysmithmd@netscape.net.
authors.forename: Gary
authors.initials: G
authors.lastname: Smith
authors.affiliation: Bureau of Emergency Medical Services, Arizona Department of Health Services, 150 N. 18th Avenue, #540, Phoenix, AZ 85007, United States. Electronic address: martha.nunez@azdhs.gov.
authors.forename: Martha
authors.initials: M
authors.lastname: Nunez
authors.affiliation: Arizona State University, Phoenix, AZ, United States. Electronic address: Madalyn821@gmail.com.
authors.forename: Madalyn
authors.initials: M
authors.lastname: Karamooz
authors.affiliation: Department of Emergency Medicine, University of Arizona, PO Box 245057, 1501 N. Campbell, Tucson, AZ 85724-5057, United States. Electronic address: dan@aemrc.arizona.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Spaite
authors.affiliation: Bureau of Emergency Medical Services, Arizona Department of Health Services, 150 N. 18th Avenue, #540, Phoenix, AZ 85007, United States; Maricopa Medical Center, Phoenix, AZ, United States; University of Arizona College of Medicine, Phoenix, AZ, United States. Electronic address: bobrowb@azdhs.gov.
authors.forename: Bentley
authors.initials: B
authors.lastname: Bobrow
mesh_terms: D000368:Aged; D001130:Arizona / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003625:Data Collection; D004632:Emergency Medical Services; D005260:Female; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Cardiac arrest; Cardiopulmonary resuscitation; Compression depth