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CPR with mouth-to-mouth is better for kids, researchers say

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Since 2008, the American Heart Assn. has recommended a “hands only” approach to CPR, emphasizing the importance of performing rapid chest compressions on victims of sudden cardiac arrest. The group decided to nix the mouth-to-mouth portion of cardiopulmonary resuscitation in part because studies show that it doesn’t improve overall survival, and in part to increase the odds that a bystander would perform any kind of CPR at all.

But a new study finds that the old-fashioned version of CPR is more effective at resuscitating children in cardiac arrest.

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Japanese researchers examined the medical records of 5,170 minors (ages 17 and younger) who were treated by emergency medical personnel for an out-of-hospital cardiac arrest in the years 2005, 2006 and 2007. Unfortunately, only 9% of those children survived, and even fewer – 3% – had a “favorable neurological outcome.” But the ones who got CPR from a bystander stood a much better chance of preserving their neurological function than those who didn’t – 4.5% vs. 1.9%, according to a report being published online Wednesday by the journal Lancet.

The researchers also found that conventional CPR was more likely to result in a “favorable neurological outcome” than compression-only CPR. In their analysis, 7.2% of children given chest compressions and mouth-to-mouth had a good outcome, compared with 1.6% of kids who got compressions only.

In a commentary accompanying the study, Spanish researchers say the reason is probably that most cases of sudden cardiac arrest in children – 71% in the Japanese study and more than 90% in other studies – are probably caused by non-cardiac events. (Only about a third of cases in adults are thought to have non-cardiac origins.) In such cases, mouth-to-mouth resuscitation is helpful. When cardiac arrest has a cardiac cause, either type of CPR works equally well.

They conclude that bystanders should continue to provide traditional CPR to children in cardiac arrest.

-- Karen Kaplan

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