ROC CCC
Resuscitation Outcomes Consortium Continuous Chest Compressions Trial
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 23,711 adults with out-of-hospital cardiac arrest, continuous chest compressions by EMS did not improve survival to discharge versus interrupted compressions.
N
23 711
Schéma
Cluster-randomized trial with crossover across 114 EMS agencies in the USA and Canada; adults with non-trauma out-of-hospital cardiac arrest received either continuous chest compressions with asynchronous positive-pressure ventilation or compressions interrupted for ventilation at a 30:2 ratio; CPR process measures monitored compliance.
Critère
Primary: survival to hospital discharge. Secondary: survival with favourable neurologic function (modified Rankin scale ≤3) and hospital-free survival.
RésultatSurvival to discharge 9.0% (1129/12,613) with continuous vs 9.7% (1072/11,035) with interrupted compressions (difference −0.7 percentage points, 95% CI −1.5 to 0.1; P=0.07). Favourable neurologic function 7.0% vs 7.7% (difference −0.6 points, 95% CI −1.4 to 0.1; P=0.09). Hospital-free survival was shorter with continuous compressions (mean difference −0.2 days, 95% CI −0.3 to −0.1; P=0.004).
Nichol G, Leroux B, Wang H, et al. Trial of Continuous or Interrupted Chest Compressions during CPR. N Engl J Med. 2015;373(23):2203-2214. 10.1056/nejmoa1509139