A Japanese study has shown that children who suffering from a cardiac arrest out of hospital can have a positive neurologic outcome when provided with a CPR by a bystander. As per the findings of the study, bystander cardiopulmonary resuscitation doubled the chances of a favorable/ positive neurologic outcome (category 1 or 2 of Glasgow- Pittsburg cerebral performance) compared to the outcome when no CPR is offered, according to new findings reported in The Lancet.

Conventional CPR is highly recommended

Tetsuhisa Kitamura of Tokyo Surugadai Nihon University Hospital and colleagues however concluded that kind of CPR provided did matter, depending on the cardiac arrest origin. It was also found that adolescents and children who had non-cardiac arrests performed much better when unconventional CPR was offered (chest compression and rescue breathing). Among the people with arrests related to cardiac, either chest compression or conventional CPR alone aided to improve their overall outcome to the same degree. The researchers said that based on the new data they had, they strongly recommended the use of conventional CPR, with rescue breathing included to continue being used as the standard method of treatment for children experiencing cardiac arrests out of hospital with non-cardiac causes.

In addition, since the overall outcome for the group of patients improved with CPR, whether compression only or conventional CPR was used, bystanders are highly advised to offer compression – only CPR rather than providing no form of CPR. It is also important to keep in mind that American Heart Association advocates for bystander chest compression only CPR only for adults with a cardiac arrest but not for children. Bystander CPR with rescue breathing and chest compression or just chest compression alone can help improve survival rate in adults. And in any case, it is easy to learn and perform chest compressions compared to conventional CPR, according to the study findings.

The effectiveness of bystander CPR in adults and children

In contrast to the status of CPR in adults, there have been no studies shown to support the fact that bystander CPR can help improve results in children suffering from out of hospital cardiac arrests. In fact, there is a high likelihood that pediatric out of hospital cardiac arrests are more related to respiratory attacks rather than being a cardiac arrest according to authors. Moreover, other studies that involved animal version of cardiac arrests associated with respiratory causes shows that both chest compressions and rescue breathing can result in a much better outcome. This shows that children shouldn’t be given bystander CPR with chest compression only.

While trying to shed more light on children bystander CPR, the research team undertook an observational research on out of hospital children cardiac arrests. They found that children aged below 1 year showed a poor response with very little positive neurologic outcomes. The team advised that a two tier CPR training should be provided: the general population to go for compression only CPR training while people with a high likelihood of witnessing pediatric arrests like educators, healthcare personnel and parents being taught on conventional CPR.