Resuscitation in out-of-hospital cardiac arrest—how quickly it is done may be more important than who does it

Out-of-hospital cardiac arrest (OHCA) in individuals experiencing a heart attack is a critical medical emergency that requires immediate cardiopulmonary resuscitation (CPR).

In recent research presented at the ESC Acute CardioVascular Care congress in Florence, Italy, a team of researchers led by Prof. Aneta Aleksova, along with Dr. Alessandra Lucia Fluca and Dr. Milijana Janjusevic from the University of Trieste, Italy, in collaboration with interventional cardiologist Dr. Andrea Perkan, concluded that the speed at which CPR is initiated is more crucial for survival and long-term outcomes in OHCA cases than the identity of the rescuer.

The study highlighted the importance of public education and Basic Life Support (BLS) training to increase survival rates in OHCA cases, especially since a significant number of these incidents occur in residential settings.

The researchers analyzed data from 3315 patients with ST-elevated myocardial infarction (STEMI) over a 22-year period at University Hospital Trieste, where 172 of them experienced OHCA and 44 received CPR from bystanders. The study showed a notable increase in the proportion of patients receiving bystander-initiated CPR over the years.

Overall, the study emphasized the significance of immediate resuscitation in improving survival rates after out-of-hospital cardiac arrest, regardless of the type of rescuer involved. Factors such as time to return of spontaneous circulation (ROSC), age, and left ventricular ejection fraction (LVEF) were identified as predictors of in-hospital mortality.

While the survival rates observed in the study were higher than average for OHCA patients, the researchers attributed this to several factors, including the type of heart attack the patients experienced, the level of CPR training among bystanders, and the efficiency of emergency health systems in responding to such emergencies.