CPR: Mouth-to-Mouth Not Much Help
Study: Chest Compression, Not Mouth-to-Mouth, Best Resuscitation for Adults
March 16, 2007 -- For adults who suddenly collapse, CPR is more effective if
rescuers focus on chest compression over mouth-to-mouth ventilation.
CPR stands for cardiopulmonary resuscitation. It's used on people whose
hearts suddenly stop beating. Using this emergency technique, you can keep a
person alive until professional help arrives.
Currently, CPR includes two techniques. The first is mouth-to-mouth
resuscitation, the so-called breath of life. The other is chest compression:
pushing down hard on a victim's chest, more than once a second, pressing it
down at least an inch and a half before releasing.
A major reason why bystanders don't give CPR to people who suddenly collapse
is reluctance to put their mouths on the mouth of a stricken person. That
reason no longer exists.
Now, for adults who suddenly collapse, there's powerful evidence that chest
compression alone is far better than doing nothing. In fact, the new evidence
suggests that by interrupting lifesaving chest compressions, mouth-to-mouth
resuscitation may do more harm than good.
The striking evidence comes from Ken Nagao, MD, of Surugadai Nihon
University Hospital in Tokyo, and colleagues. The researchers took a careful
look at what happened to 4,068 adults who had an out-of-hospital cardiac arrest
witnessed by bystanders.
More than 70% of the time, the bystanders did nothing when a person suddenly
collapsed. Those victims were less likely to survive, and more likely to have
brain damage if they did survive, than when bystanders tried to do
Bystanders bravely gave traditional CPR to 18% of victims. And those
patients did much better than those who got no bystander aid.
But victims were 2.2 times less likely to suffer brain damage if they were
among the 11% of patients who got chest compressions only -- without
Death of Mouth-to-Mouth Resuscitation?
"This study just confirms what has pretty much become common
knowledge," CPR researcher Alfred Hallstrom, PhD, of the University of
Washington in Seattle, tells WebMD. "We did a randomized trial of
compressions vs. CPR, and the results indicated that the compression-only
technique was better. Subsequently, labs have done animal studies suggesting
the same thing."
"This does not surprise me one bit," CPR researcher Joseph W.
Heidenreich, MD, of Texas A&M Health Science Center, tells WebMD. "This
is what all of us who have done CPR research have suspected for years. This is
amazing data. Primarily, what people who suffer cardiac arrest need are chest
But not everyone is willing to give up on teaching people to give
mouth-to-mouth resuscitation. One of them is Lance Becker, MD, director of the
center for resuscitation science at the University of Pennsylvania and past
chair of the basic life support subcommittee of the American Heart Association
"The real message from this study is that doing something is better for
saving people's lives than doing nothing," Becker tells WebMD. "Good
compressions are associated with good things. It does not mean that ventilation
is not an excellent thing as well."