Continuous Chest Compression CPR Versus Standard CPR for In-Hospital Cardiac Arrest

Insights

Pauses in chest compressions to deliver ventilations may contribute to reduced coronary artery and aortic blood flow and poor clinical outcomes. Providing positive pressure ventilations asynchronously (without pausing compressions) may improve chest compression quality without compromising oxygenation. There is no direct evidence from the inpatient setting to provide guidance. However, limited evidence from cardiac arrests in the out-of-hospital setting failed to show a difference in patient outcomes with continuous chest compressions with asynchronous ventilations at a rate of 10 per minute compared with 30:2 standard compression-to-ventilation cardiopulmonary resuscitation (CPR) prior to intubation. Similar to guidelines for EMS, guidelines for in-hospital cardiac arrest allow for the choice of standard compression-to-ventilation CPR (which allows for immediate CPR), or for continuous chest compressions with asynchronous ventilation, with or without an advanced airway.