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MedUni Vienna meta-study: Better chance of survival without mouth-to-mouth resuscitation

(Vienna, 15 October 2010) Physicians of MedUni Vienna have been able to prove in a study that in certain cases of acute cardiac arrest, attempts at resuscitation without artificial respiration have a higher chance of success. This sensational study has also been published in the renowned medical journal "The Lancet".

For some time physicians have been trying to find out if, after acute cardiac arrest, attempts at resuscitation conducted by laymen who follow instructions given by the emergency centre should be carried out with or without mouth-to-mouth resuscitation. Three studies that have recently been published on this subject could find any real differences between the methods.

Dr. Michael Hüpfl, Dr. Harald F. Selig and Ao.Univ. Prof. Dr. Peter Nagele from the Department of Anaesthesia, Intensive Care and Pain Therapy of MedUni Vienna found in these studies that the number of probands was possibly too low to achieve any significant result. Therefore they combined the three studies into one meta-study. Thus they could prove in a very time-consuming statistical procedure that there was nevertheless a considerable difference and that the success rate without artificial respiration was some 22% higher.

The present study has concluded that the resuscitation without artificial respiration of adult patients, who had an acute cardiac arrest whilst not in hospital, by laymen following instructions given by phone by the emergency centre had a greater chance of success. The physicians assume that in this case there is still sufficient oxygen in the system. However, mouth-to-mouth resuscitation in cases of cardiac arrest due to an accident or after drowning, for example, still needs to be conducted, especially with regard to children, who frequently suffer cardiac arrest due to lack of oxygen.

"This finding finally provides a clear basis for decision-making by the physicians on duty at emergency centres about which instruction on resuscitation needs to be given if it can be ruled out without any doubt that the acute cardiac arrest of an adult has occurred with intervention from outside." comments Hüpfl in the study's finding.

» Publication in "The Lancet":
Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis
Michael Hüpfl, Harald F Selig, Peter Nagele

Zu den Personen:
Ao.Univ. Prof. Dr. Peter Nagele, born in 1971, was awarded his doctorate in 1995, completed his training as an emergency doctor in 2004 and qualified as a professor in the subject of anaesthesiology and intensive medicine in 2005. Since then he has also worked in this field as an associate university professor.
Nagele currently lives in the US, where he works at the Washington University School of Medicine as Head of the Department of Anesthesiology, where he also obtained his MSc in Clinical Investigation (2009) and Genetic Epidemiology (2010).
As well as his teaching career at MedUni Vienna (clinical training, dissertations, etc.) he focuses in his research, among other subjects, on pharmacogenomics and "personalized medicine" as well as cardiovascular complications within perioperative outcome research.
Nagele has been awarded a large number of national and international prizes, is active as a reviewer for various research journals and has already published many publications. In addition he is a member of various medical societies and has been the President of the Austrian Scientist and Scholars in North America (ASCINA) since 2008.

Dr. Harald F. Selig, born in 1984, was awarded his doctorate at MedUni Vienna in 2009 and is currently completing his doctoral studies of applied medical sciences. Between 2007 and 2009 the focus of his research work was on "paediatric emergencies in air rescue services", which was also the topic of his diploma thesis. At present he deals with the subject "skin substitutes in deep dermal burns".

Dr. Michael Hüpfl, born in 1965, completed his medical studies at MedUni Vienna in 1991 and his specialisation training in anaesthesia and intensive care medicine in 2001. He is active in many fields of air emergency services, among other positions as chief physician of St. John Ambulance Vienna and chairman of the educational subcommittee of the European Trauma Course. In this framework he also holds various lectures and works in initial and further training.