Bystander CPR Technique and Outcomes for Cardiac Arrest With and Without Opioid Toxicity

PMCID: PMC12175020

PMID: 40526383

DOI: 10.1001/jamanetworkopen.2025.16340

Journal: JAMA network open

Publication Date: 2025-6-17

Authors: Grunau B, Lee M, Buxton JA, Mok V, Helmer J, et al.

Key Points

• Bystander CCV-CPR showed statistically significant improved outcomes in opioid-associated out-of-hospital cardiac arrests
• The study analyzed a large cohort of 10,913 cardiac arrest cases across different intervention groups
• Ventilatory support may be a critical intervention specifically for opioid-related cardiac arrest scenarios

Summary

This cohort study investigated the effectiveness of chest compression with ventilation (CCV-CPR) versus chest compression-only CPR (CC-CPR) in two distinct out-of-hospital cardiac arrest (OHCA) populations: opioid-associated (OA-OHCA) and undifferentiated cardiac arrests. The research analyzed 1,357 opioid-associated and 9,556 undifferentiated OHCA cases to determine optimal bystander resuscitation techniques.

The study revealed a critical distinction in CPR approach: CCV-CPR demonstrated improved outcomes specifically in opioid-associated cardiac arrests, while showing no significant benefit in undifferentiated cardiac arrest cases. This finding suggests that the optimal resuscitation strategy may vary depending on the underlying cardiac arrest etiology, with ventilatory support potentially playing a crucial role in opioid-related cardiac emergencies.