Sustaining CPR that long also improves the chances that survivors will have normal brain function, researchers said.
Cardiac arrest occurs when electrical impulses in the heart become rapid or chaotic, causing it to suddenly stop beating.
Nearly 360,000 cardiac arrests occur outside of a hospital each year in the United States. Fewer than 10 percent survive.
Research has found that early return of spontaneous circulation — the body pumping blood on its own — is important for people to survive cardiac arrest with normal brain function. But little research has focused on the period between cardiac arrest and any return of spontaneous circulation.
Using a massive registry tracking all out-of-hospital cardiac arrests in Japan in 2005-11, researchers studied how much time passed between survivors’ collapse and the return of spontaneous circulation, and how well brain function was preserved a month later.
Survivors were considered to have fared well neurologically if they were alert and able to return to normal activities, or if they had moderate disability but were well enough to work part-time in a sheltered environment or take part in daily activities independently.
The time between collapse and return of spontaneous circulation for those who fared well was 13 minutes compared to about 21 minutes for those who suffered severe brain disability, said Ken Nagao, M.D., Ph.D., professor and director-in-chief of the Department of Cardiology, CPR and Emergency Cardiovascular Care at Surugadai Nihon University Hospital in Tokyo.
After adjusting for other factors that can affect neurological outcomes, researchers found that the odds of surviving an out-of-hospital cardiac arrest without severe brain damage dropped 5 percent for every 60 seconds that passed before spontaneous circulation was restored.
Based on the relationship between favorable brain outcomes and the time from collapse to a return of spontaneous circulation, the researchers calculated that CPR lasting 38 minutes or more was advisable.
“It may be appropriate to continue CPR if the return of spontaneous circulation occurs for any period of time,” said Nagao.
The 2010 AHA Guidelines for CPR and ECC advise bystanders to perform CPR until emergency crews arrive.
The Japanese Circulation Society Resuscitation Science Study group conducted the study.
Stories appearing on blog.heart.org under the "By American Heart Association News" byline are available for linking, quoting, excerpting and reprinting. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered and proper attribution is made to the American Heart Association. Additional conditions may apply to the use of these stories in printed materials.
American Heart Association additional conditions for linking, quoting, excerpting, reprinting stories in print media
- A credit line of American Heart Association News must be prominently placed on the page in which the American Heart Association materials appear.
- The American Heart Association logo and service marks may only be used if they appear on the materials requested.
- Stories reprinted may be edited for length, but no other deletions, alterations or other changes may be made without the prior written consent of the American Heart Association.
- Artwork labeled "American Heart Association" may be reprinted, but other artwork may not. For artwork permission questions, contact firstname.lastname@example.org
- Stories reprinted may not be placed adjacent to any advertisement, photo, graphic or other content that could be considered inappropriate by the American Heart Association. For questions about whether content is inappropriate, contact email@example.com.
- Stories may not be displayed in any way that gives the appearance that the American Heart Association endorses (implied or otherwise) or is affiliated with any product, service or company.