Mouth-To-Mouth Resuscitation May No Longer Be an Affective Way to Save Lives

A large Japanese study has shown that victims of cardiac arrest have a 50 % higher chance of survival if someone gives them heart massage alone instead of combining it with breathing into their lungs.

The "Kiss of Life," also known as mouth-to-mouth resuscitation, has been a regularly taught and practiced approach to resuscitation for 50 years.

The study investigated the medical histories of 4068 people who suffered from a heart attack and collapsed in the presence of another person. Almost three-fourths of these victims received no resuscitation at all. Of the remaining persons studied, however, those who received only heart compressions were 50% more likely to be alive and without brain damage a month later.

Only a minute portion of those studied actually survived: 6% of those that received only heart compressions as opposed to 4% that received traditional CPR.

Ken Nagao, the study's leader and a doctor at Tokyo's Suragadai Nihon University Hospital, has stated several reasons as to why chest compressions alone might be the best approach instead of the traditional cardiopulmonary resuscitation (CPR).

Chest compressions are meant to re-establish blood flow to the heart. If they have not already done so, then stopping to perform mouth-to-mouth ventilation may actually cause harm instead of helping the victim. Nagao also pointed out that people are very hesitant to lock lips with a stranger, but are much more likely to attempt hands-only resuscitation.

"This reluctance is party caused by fear of transmission of infectious diseases," Dr. Nagao wrote in the medical journal The Lance. "Another barrier to bystanders attempting CPR is the complexity of the technique as presently taught."

Most patients who suffer brain damage from sudden cardiac arrest do not survive, says resuscitation researcher, Gordon Ewy of the University of Arizona.

Ewy says that a person who has just suffered a heart attack still has enough oxygen in their blood to sustain their body for several minutes. The compressions can help the heart recover while that surplus of oxygen is being used. He believes that there is a much higher benefit from continuous chest compressions, where rescue-breathing stops such action too soon.

"The forward blood flow that you get from pumping on the chest is so marginal that if you stop for anything it's bad for the brain," says Ewy, discussing the risk of oxygen deprivation that can lead to brain damage.

Experts did note that mouth-to-mouth resuscitation may still offer benefits in the cases of drug overdose or drowning, when the heart has not been beating for several minutes. In these cases, the rescue breathing may boost already low oxygen levels in the blood.

Ian Jacobs is the chairman of the Australian Resuscitation Council and says he is not completely convinced changes need to occur to the traditional methods of CPR. He does emphasize, however, that "any resuscitation attempt is better than no attempt."

Sources used for this article:

http://www.smh.com.au/news/world/cardiac-arrest-forget-the-kiss-of-life/2007/03/16/1173722744307.html
http://www.newscientist.com/article/dn11393-kiss-of-life-increases-risk-after-heart-attack.html