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Association of rescue breathing with outcomes in adult suffocation-related cardiac arrest.
Asami Okada1, Takeichiro Tominaga1, Masahiro Iwakura1
1Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Japan.
Resuscitation
|June 26, 2026
Summary
In suffocation-related out-of-hospital cardiac arrest (OHCA), neither compression-only CPR nor CPR with ventilation significantly improved neurological outcomes compared to no CPR. The type of bystander CPR did not appear to be the primary factor in patient recovery.
Area of Science:
- Emergency Medicine
- Cardiology
- Public Health
Background:
- Out-of-hospital cardiac arrest (OHCA) presents a significant public health challenge.
- The effectiveness of different bystander cardiopulmonary resuscitation (CPR) methods in suffocation-related OHCA remains unclear.
Purpose of the Study:
- To investigate the impact of bystander CPR type on neurological outcomes in suffocation-related OHCA.
- To compare chest compression-only CPR (CC-CPR), chest compression plus ventilation CPR (CCV-CPR), and no bystander CPR (No CPR).
Main Methods:
- Retrospective cohort study utilizing the All-Japan Utstein Registry (2005-2023).
- Included adult patients with witnessed suffocation-related OHCA, excluding cardiac origins.
- Applied Inverse Probability of Treatment Weighting (IPTW) for analysis.
Main Results:
- No CPR was associated with better neurological outcomes (aOR: 1.20) and survival (aOR: 1.20) compared to CC-CPR.
- CCV-CPR showed no significant difference in neurological outcomes or survival compared to CC-CPR.
- No significant differences were observed for return of spontaneous circulation (ROSC) across groups.
Conclusions:
- Bystander CPR type was not linked to improved neurological recovery in suffocation-related OHCA.
- The findings suggest that CPR method alone may not be the main driver of recovery.
- Further research is needed to clarify the roles of CPR technique, airway management, and other prehospital factors.
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