A small body of
animal and human research suggests, perhaps surprisingly, that
mouth-to-mouth ventilation may not improve outcomes for patients who
undergo cardiopulmonary resuscitation after out-of-hospital cardiac arrest.
To test this theory, researchers in
Survival to
hospital discharge was 14.6 percent among those patients who
received chest compression alone, and 10.4 percent among those who
received chest compression plus mouth-to-mouth ventilation (P=0.18).
Dispatchers were able to complete their instructions completely in
81 percent of the former cases but in only 62 percent of the latter
-- a significant difference.
Comment: In this study, untrained bystanders who performed
chest compression without mouth-to-mouth ventilation were at least
as effective as those who provided CPR with both maneuvers. The
implications of these results are considerable, because performing
mouth-to-mouth ventilation makes CPR more complicated and deters
some people from wanting to do CPR at all. Whether these results
would hold for CPR done by rigorously trained people is unclear. In
any case, an editorialist -- a CPR researcher -- states that this
report is "of immense importance and will have worldwide
implications."
— AS Brett
Published in Journal Watch Dermatology August 1, 2000
Originally published in Journal
Watch June 9, 2000
Source
Hallstrom A et al. Cardiopulmonary
resuscitation by chest compression alone or with mouth-to-mouth ventilation. N
Engl J Med 2000 May 25 342 1546-1553.
Ewy
GA. Cardiopulmonary resuscitation -- strengthening the links in the chain of
survival. N Engl J Med 2000 May 25 342 1599-1601.