These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Three-phase model of cardiac arrest: time-dependent benefit of bystander cardiopulmonary resuscitation.
    Author: Gilmore CM, Rea TD, Becker LJ, Eisenberg MS.
    Journal: Am J Cardiol; 2006 Aug 15; 98(4):497-9. PubMed ID: 16893704.
    Abstract:
    Evidence has suggested that the pathophysiology of ventricular fibrillation cardiac arrest may consist of 3 time-sensitive phases: electrical, circulatory, and metabolic. We performed a retrospective cohort study of adults in a metropolitan county who had had witnessed ventricular fibrillation arrest before emergency medical services were undertaken to investigate this 3-phase model with regard to bystander cardiopulmonary resuscitation (CPR). We hypothesized that the survival benefit from bystander CPR depends on the collapse-to-shock interval, with the highest benefit occurring during the circulatory phase. The collapse-to-shock interval was a priori grouped into 4 categories: 1 to 5, 6 to 7, 8 to 10, and > or = 11 minutes. We used logistic regression analysis to assess whether the association between CPR and survival to hospital discharge depended on the collapse-to-shock interval category. Of the 2,193 events meeting the inclusion criteria, 67.0% had received bystander CPR. The average collapse-to-shock interval was 8.2 +/- 2.8 minutes. The survival rate was 33.4%. A higher likelihood of survival was associated with bystander CPR (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.15 to 1.73) and a shorter collapse-to-shock interval (OR -1.84, 95% CI 1.62 to 2.10, for each additional SD of 2.8 minutes less) after adjustment. The beneficial association of CPR increased as the collapse-to-shock interval increased (p = 0.05 for interaction). The bystander CPR was associated with an OR of survival of 0.96 (95% CI 0.64 to 1.46) for a 1- to 5-minute collapse-to shock interval, OR of 1.25 (95% CI 1.00 to 1.58) for a 6- to 7-minute interval, OR of 1.62 (95% CI 1.25 to 2.11) for an 8- to 10-minute interval, and OR of 2.11 (95% CI 1.32 to 3.37) for an > or = 11-minute interval. The results of this investigation support a phased model of ventricular fibrillation arrest. The findings suggest that the transition from the electrical to circulatory phase may occur at about 5 minutes, and the circulatory phase may extend to 15 minutes.
    [Abstract] [Full Text] [Related] [New Search]