A Randomized Controlled Trial of Compression Rates (COMPRATE trial) During Cardiopulmonary Resuscitation

Abstract

Purposes: This prospective, randomized, multicenter-, controlled trial was conducted to compare the efficacy of CPR with compression rate of 100/min to CPR with compression rate of 120/min in patients with cardiac arrest.Methods: Patients with non-traumatic out-of-hospital cardiac arrest whose age is equal and over 19 years old were randomized into two groups when the patient arrived at emergency department. The patients received manual CPR either a compression rate of 100 /min (CPR-100 group) or a compression rate of 120/min (CPR-120 group). Chest compressions were performed by pre-trained AHA certified healthcare providers according to guidance of metronome and a real-time CPR measurement feedback system. Quality of chest compression was assessed by reviewing the depth and rate of compressions recorded in the high quality electronic monitoring system of the defibrillator. The case was excluded if the accuracy of the depth and rate of chest compressions could not be maintained over 90%. The primary outcome measure was sustained return of spontaneous circulation (ROSC). The secondary outcome measures were survival discharge from the hospital, 1-month survival, and 1-month survival with good functional status, categorized as a score of 2 or less on the cerebral performance category.Results: 470 patients were enrolled in the study. 221 patients were assigned to CPR-100 group and 249 patients assigned to CPR-120 group. A total of 136 patients (61.5 %) in the CPR-100 group and 156 patients (62.7 %) in the CPR-120 group were included in the analysis. In comparison of primary outcome, 69 patients (50.7%) in CPR-100 group and 67 patients (42.9%) in CPR-120 group had ROSC (p=0.183). In secondary outcome measures, the rates of survival discharge from the hospital, 1-month survival, and 1-month survival with good functional status were not different between two groups (16.9% vs. 12.8%, p=0.375; 12.5% vs. 6.4%, p=0.073; 5.9% vs. 2.6%, p=0.154).Conclusions: In patients with out-of-hospital non-traumatic cardiac arrest resuscitated in emergency department, no differences in the resuscitation outcomes were found between those who received CPR with a compression rate of 100/min and those who received CPR with a compression rate of 120/min.