Deep chest compressions reduce brain damage and improve survival during cardiac arrest due to improved blood flow to the brain, according a new study presented at European Society of Cardiology (ESC) Congress.

There have been recent concerns that chest compression can lead to CPR-related injuries, but the study found that patients with CPR-related injuries were more likely to have better brain performance.

Nearly two-thirds (65.1%) of patients with injuries had high brain function compared to 43.2% without injuries (p<0.01). The most common injuries were rib or sternal fractures.

Authors of the study said people might be more reluctant to perform CPR during the Covid-19 pandemic due to fear of infection, but added that chest compressions alone may be as effective as conventional CPR.

The study limited participation to comatose survivors of cardiac arrest, since they would have received prolonged resuscitation. In contrast, survivors who regain consciousness have generally received an immediate electric shock and brief chest compressions to restore circulation.

In 2006 to 2020, the study enrolled consecutive patients admitted to an acute cardiac care unit after a cardiac arrest in hospital or in the community. Patients were divided into three groups corresponding to updates of the CPR guidelines: 2006–2010, 2011–2015, and 2016–2020.

Survival and neurological outcome of cardiac arrest patients improved significantly 

The study included 510 patients who survived cardiac arrest and were admitted to hospital while unconscious. The average age was 63 years and 81% were men. CPR by lay bystanders and the use of automated external defibrillators (AEDs) progressively increased over the study period.

After 2010, there was a higher proportion of CPR-related injuries: 12.7% in 2006–2010, 23.5% in 2011–2015, 22.7% in 2016–2020 (p=0.02). Just over half of patients survived and were discharged from the hospital (51.6%). Brain performance at three months significantly increased over the course of the study (i.e. it was highest in the 2016–2020 group).

Study author Dr. Irene Marco Clement of University Hospital La Paz, Madrid, Spain said: “We wanted to analyse the effect of deep chest compressions during prolonged resuscitation, when they could make a real difference to outcomes. Survival and neurological outcome improved significantly during the 14-year study."