In a groundbreaking study supported by the National Institutes of Health (NIH), researchers have discovered that the quality and frequency of ventilation, or rescue breathing, during cardiopulmonary resuscitation (CPR) can significantly impact the survival rates of patients experiencing cardiac arrest. The findings, published in the journal Circulation and presented at the American Heart Association's Resuscitation Science Symposium 2023, suggest that improved ventilation techniques could potentially save more lives.

Ventilation involves administering breaths to a patient to provide life-sustaining oxygen and inflate the lungs when they stop breathing or during cardiac arrest. However, the study revealed that professional emergency responders often perform this technique poorly, leading to ineffective strategies and lower patient survival rates.

The study, largely funded by the National Heart, Lung, and Blood Institute (NHLBI), part of NIH, analyzed data from nearly 2,000 people who received CPR for out-of-hospital cardiac arrests between June 2011 and May 2015 in six cities across the United States and Canada. Researchers compared ventilation measurements to patients' health outcomes after reaching the hospital.

The results were staggering. Patients who received a higher number of effective ventilations, estimated to be about 12 on average during the CPR session, had survival rates three times greater than those who received fewer ventilations, approximately two on average per session. This group also experienced a resumption of a sustained heart rhythm in greater numbers and had a higher rate of survival with good neurological outcomes, indicating a low probability of brain damage.

The study's findings highlight the urgent need for improved CPR guidelines and practices among emergency responders. If more resuscitation efforts adhere to recommended guidelines, including providing four effective ventilations per minute and using proper techniques, an estimated 15,000 more people might reach the hospital alive and leave alive.

Lead author Dr. Ahamed Idris, director of emergency medicine research at the University of Texas Southwestern Medical Center, expressed surprise at the magnitude of the results, stating, "While we suspected that better ventilation was going to show some benefit to patients, the result that we got was much more than we expected."

According to the American Heart Association, over 356,000 people in the United States experience out-of-hospital cardiac arrests each year, with only about 10% surviving. The study's findings emphasize the potential impact of improved ventilation techniques on increasing survival rates.

The study also identified several factors contributing to the low ventilation frequency recorded during CPR. These include ventilation not being measured when using a bag-mask device, poor CPR techniques or mechanics resulting in air leaks, and inconsistent use of a device to prevent the tongue from blocking the airway.

In light of these findings, researchers urge emergency medical services agencies to provide means for paramedics to monitor and measure ventilation when using a bag-mask device, enabling them to identify and rectify ineffective ventilation attempts.

The NIH-funded study underscores the importance of not only increasing chest compressions but also improving ventilation efforts in CPR. Dr. George Sopko, program director of the resuscitation branch of NHLBI's Division of Cardiovascular Sciences, emphasized the significance of the study's findings in guiding future resuscitation techniques.

With this new knowledge, the research community and emergency responders can work together to enhance CPR practices, ultimately leading to improved patient outcomes and potentially saving more lives.

The National Heart, Lung, and Blood Institute (NHLBI), the global leader in research on heart, lung, and blood diseases, is devoted to advancing scientific knowledge, improving public health, and turning discoveries into health solutions.

The National Institutes of Health (NIH), the nation's premier medical research agency, conducts and supports research in various areas, including heart, lung, and blood diseases. NIH's commitment to investigating the causes, treatments, and cures for both common and rare diseases plays a crucial role in promoting public health and well-being.