Sudden cardiac arrest poses a severe threat to life, with survival chances dropping to near zero beyond 10 minutes of rescue efforts. For out-of-hospital cardiac arrest victims, high-quality CPR performed by bystanders is crucial for successful rescue, where compression rate and depth are key factors ensuring CPR quality.The Chinese Public Health Guidelines for Cardiopulmonary Resuscitation recommend a compression rate of 100–120 compressions per minute and a compression depth of 5–6 cm (1–2 inches) during chest compressions. The American CPR Guidelines offer similar recommendations, specifying a minimum compression depth of 5 cm (2 inches).
Researchers from the University of Minnesota Medical School, Grenoble-Alpes University in France, and Toho University in Japan recently conducted a cohort study.The study included 3,643 cardiac arrest patients from the National Institutes of Health Clinical Trials Network database. Among them, 64% were male, with an average age of 67.5 years. Half of the patients received conventional CPR alongside automated external defibrillators (AEDs). Good functional survival—defined as survival without significant disability—was measured using a modified Rankin Scale score ≤3 (used to assess neurological recovery after stroke).
Results showed that during out-of-hospital cardiac arrest resuscitation via chest compressions, the highest probability of survival without significant disability occurred at a compression rate of 105–109 compressions per minute and a compression depth of 4.5–5 cm. Thus, researchers concluded that the optimal compression rate is 107 compressions per minute, with an optimal depth of 4.7 cm.When compression rate and depth fell within 20% of these values—specifically 86 to 128 compressions per minute and 3.8 to 5.6 cm depth—survival rates for cardiac arrest patients increased by 44% compared to those receiving compressions outside this range.
Published in JAMA Cardiology, the study concluded that its findings largely align with current international guidelines.Therefore, until further validation of these optimal compression rates and depths, emergency systems should continue to follow current recommendations. While this finding is not sufficient to alter international CPR guidelines, it reinforces the simplest principle of CPR: compress hard, compress fast, and keep going.