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Modifying the standard way of giving CPR leads to better survival of people who've suffered a heart attack, US researchers report. The trick is to give more chest compressions with less time spent pushing air into the lungs.

"It takes 5-7 chest compressions to raise the pressure enough to begin driving blood into the heart tissue," lead author Dr. Alex G. Garza explained in a statement. "If you stop too often to provide a couple of breaths, then you haven't helped the heart much and you have to start building pressure all over again."

With the modified protocol, 50 chest compressions are given before the rescuer pauses to give 2 breaths, while the American Heart Association's guidelines recommend 30 compressions before the breaths are given.

The new routine also advises delays in emergency activity such as trying to get an airway tube into the patient or giving medications, in order to focus on the chest compressions.

The Kansas City Emergency Medical Services adopted the new routine in 2006. Garza, from the Georgetown University School of Medicine, Washington, DC, and his team assessed the outcomes of adults who went into cardiac arrest there and who were treated 36 months before or 12 months after the modified resuscitation procedure was implemented.

With use of the new protocol, survival for out-of-hospital cardiac arrest increased from 7.5% (82 of 1097 attempted resuscitations) to 13.9% (47 of 339 attempts). The findings are reported in the American Heart Association's journal Circulation.

Among the subjects who made it to the hospital, survival rates were also improved with the new procedure, rising from 22.4% (32 of 143) to 43.9% (25 of 57). Of the latter 25 patients, 22 had good brain function.

Further research, the authors conclude, is needed to verify these findings.

SOURCE: Circulation, May 19, 2009.
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