Quality and outcome of cardiopulmonary resuscitation

Important factors in a successful resuscitation are optimal chest compression rate of 100/min, a compression depth of 5 cm and minimization of pauses in chest compressions. This constitutes ‘high quality’ CPR. The first part of this thesis focuses on assessing this quality and how feedback devices may improve the quality. We found that the force to compress the recommended 5 cm is highly variable, difficult to achieve and can benefit from the use of feedback devices.
The second part of this thesis studies the outcome of resuscitation attempts after out-of-hospital cardiac arrest (OHCA). We showed that the survival rate has increased during the study period covered in this thesis and demonstrated the importance of automated external defibrillators (AEDs) to increase survival. We also showed that resuscitation parameters (i.e. presence of shockable initial rhythm and time to connection of a defibrillator device) and not pre-OHCA comorbidity, determine outcome after OHCA in older patients. Resuscitation parameters are, however, unknown in advance and therefore cannot be taken into account when discussing advance care planning. Resuscitation can only be considered successful if the survivor has an acceptable quality of life and has no impaired cognitive function. We showed that the great majority of survivors were independent in daily life and gave their quality of life a value of ≥6. While older persons had a lower probability of survival, their quality of life is good and comparable to a Dutch reference population of the same age.