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Longer CPR Backfires for Certain Heart Patients: Study
Date:9/1/2011

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, Aug. 31 (HealthDay News) -- More is not necessarily better when paramedics give cardiac arrest patients CPR before administering shocks to the heart, a new study finds.

On the contrary, providing CPR (cardiopulmonary resuscitation) for a longer period of time could actually harm certain patients.

"We found that extra CPR didn't help and, in fact, in some patients it was not a good thing. It would make it worse," said Dr. Ian Stiell, lead author of a paper published in the Sept. 1 issue of the New England Journal of Medicine. "Our study showed that there's no reason to do two minutes of CPR or to delay defibrillation."

But the study didn't address CPR delivered by a bystander so the message to the public is still the same.

"We absolutely believe that bystanders should start CPR right away," said Stiell, chair of emergency medicine at the University of Ottawa, Canada, and a senior scientist with the Ottawa Hospital Research Institute. "This trial doesn't address that."

Fewer than 10 percent of the 350,000 people each year in the United States and Canada who have a cardiac arrest out of the hospital survive the event.

Early CPR -- a combination of manual chest compressions and rescue breathing -- increases blood flow and is thought to put the heart in better shape to receive and respond to defibrillation, which restores a normal heart rhythm.

But how much CPR is optimal remains unclear. "We all knew that the earlier to defibrillation the better . . . but no one really knew how long that period of time was," said Dr. Joseph Feldman, chairman of emergency services at Hackensack University Medical Center in New Jersey.

In guidelines released in 2010, the American Heart Association (AHA) cited "inconsistent evidence" either for or against extended CPR and any delay in heart rhythm analysis.

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