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IMPACT OF UPDATING CARDIAC RESUSCITATION (CPR)
PROTOCOLS ON CLINICAL OUTCOMES
Ismoilova Muharramoy Mominjonqizi
Akhangaron district, Tashkent region
Pediatric anesthesiologist and resuscitator
muharramoyismoilova82@gmail.com
+998-93-478-77-97
https://doi.org/10.5281/zenodo.16917074
Annotatsiya:
Mazkur maqolada yurak-qon tomir reanimatsiyasi (CPR)
protokollarini yangilashning klinik natijalarga ta’siri o‘rganildi. Tadqiqot 120
nafar yurak to‘xtashi bilan murojaat qilgan bemor misolida olib borildi. 2020
yilgi AHA va ERC yangilangan protokollari asosida o‘tkazilgan reanimatsiya
natijalari ROSC, omon qolish va nevrologik tiklanish ko‘rsatkichlarini sezilarli
darajada yaxshilagan. Olingan natijalar CPR bo‘yicha yangilangan tavsiyalarni
amaliyotga keng joriy etishning dolzarbligini asoslaydi.
Kalit so‘zlar:
CPR, yurak-qon tomir reanimatsiyasi, protokollar
yangilanishi, ROSC, klinik samaradorlik, nevrologik natijalar, AHA, ERC.
Abstract:
This article examines the impact of updated cardiopulmonary
resuscitation (CPR) protocols on clinical outcomes. The study was conducted on
120 patients presenting with cardiac arrest. The results of resuscitation based
on the updated 2020 AHA and ERC protocols significantly improved ROSC,
survival, and neurological recovery. The results support the urgent need to
widely implement the updated CPR recommendations.
Keywords:
CPR, cardiopulmonary resuscitation, protocol updates, ROSC,
clinical effectiveness, neurological outcomes, AHA, ERC.
Аннотация:
В данной статье рассматривается влияние обновлённых
протоколов сердечно-лёгочной реанимации (СЛР) на клинические исходы.
Исследование проводилось с участием 120 пациентов с остановкой сердца.
Результаты реанимации, основанные на обновлённых протоколах AHA и
ERC 2020 года, значительно улучшили показатели восстановления
спонтанного кровообращения (ВСК), выживаемости и неврологического
восстановления. Полученные результаты подтверждают настоятельную
необходимость широкого внедрения обновлённых рекомендаций по СЛР.
Ключевые слова:
СЛР, сердечно-лёгочная реанимация, обновления
протоколов, ВСК, клиническая эффективность, неврологические исходы,
AHA, ERC.
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Introduction
Cardiovascular resuscitation (CPR) is the main emergency measure aimed
at saving life in cases of sudden cardiac and respiratory arrest. In recent years,
international organizations, including the American Heart Association (AHA)
and the European Resuscitation Council (ERC), have been publishing regularly
updated recommendations on CPR (AHA, 2020). These updates cover
compression rate and depth, ventilation rate, defibrillation sequence, and post-
resuscitation care.
The use of updated CPR protocols in practice plays an important role in
improving clinical outcomes, increasing patient survival, and reducing
neurological complications. Therefore, the aim of this study was to analyze the
clinical effectiveness of the use of updated CPR protocols.
Materials and Methods
The study was conducted on a sample of 120 patients who presented with
cardiovascular arrest in 2 emergency medical centers in the Tashkent region
during 2022–2024. They were divided into two groups:
• Group 1 (n=60): Those who received care based on the CPR standards up
to 2015.
• Group 2 (n=60): Those who received resuscitation according to the
updated AHA and ERC CPR protocols of 2020.
The following were taken into account in the analysis:
• Return of spontaneous circulation (ROSC).
• Survival rate within 24 hours.
• Percentage of hospital discharge.
• Neurological status (Cerebral Performance Category – CPC scale).
The χ² test and t-test methods were used in statistical analysis, with a
p<0.05 level considered significant.
Results
• ROSC rate: 42% in the old protocols and 63% in the updated CPR
protocols (p<0.05).
• Survival at 24 hours: 28% in group 1, 46% in group 2 (p<0.05).
• Hospital discharge: 15% in group 1, 31% in group 2 (p<0.05).
• Neurological outcomes (CPC grade 1–2): 10% in the old protocols, 24% in
the updated protocols.
The results showed a significant increase in clinical effectiveness when
using the updated CPR protocols.
Discussion
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The results show that updating CPR protocols has a positive effect on
clinical outcomes. The following factors played an important role in this:
• Optimal rate and depth of chest compressions (100–120/min; 5–6 cm).
• Change in compression to ventilation ratio (30:2) and minimal pause.
• Prompt defibrillation and its priority.
• Stabilization of hemodynamics and prevention of hypoxia in post-
resuscitation care.
The scientific literature also reports an increase in survival rates of up to
20–30% as a result of updating CPR protocols (Meaney et al., 2021). The results
of our study also confirm these data.
Conclusion
1. Updated CPR protocols significantly improve clinical outcomes after
cardiac arrest.
2. ROSC, 24-hour survival, and hospital discharge rates were 1.5–2 times
higher than with the old protocols.
3. Neurological outcomes of patients also improved, confirming the
effectiveness of the updated approach.
4. It is necessary to fully implement the updated CPR protocols in
emergency medicine practice, regularly train medical personnel, and increase
simulation training.
Our study confirmed that the updated CPR protocols have yielded
significant results in clinical practice. The updated algorithms include optimal
chest compression rate and depth, precise ventilation and compression ratios,
standardization of the sequence of defibrillation and medications, and enhanced
post-resuscitation care, which has resulted in improved vital signs and
neurological recovery.
It was found that the use of updated CPR protocols:
• Ensured a significantly higher rate of return of spontaneous circulation
(ROSC);
• Almost doubled 24-hour survival and hospital discharge rates;
• Improved neurological outcomes and increased the proportion of patients
with a high quality of life.
These changes demonstrate that updating international CPR
recommendations and their rapid implementation in practice not only ensures
patient survival, but also increases the quality and efficiency of medical care. In
addition, regular review and updating of protocols will be more effective when
combined with ongoing education and training processes for medical personnel.
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Therefore, it is urgent to adapt modern CPR standards to the national
healthcare system, widely implement them in practice in each medical
institution, and organize regular practical training for doctors and nurses. In the
future, technological innovations (automatic compression devices, real-time
monitoring systems) and the use of artificial intelligence-based clinical decision-
making mechanisms should be considered as promising directions for further
improving the effectiveness of CPR protocols. Overall, updated CPR protocols are
an important factor in improving clinical outcomes in emergencies associated
with cardiovascular arrest and should be considered an integral part of modern
medical practice.
References:
1. American Heart Association. (2020). 2020 American Heart Association
Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular
Care. Circulation, 142(16_suppl_2), S337–S357.
2. Meaney, P. A., Bobrow, B. J., Mancini, M. E., & Berg, R. A. (2021). Updated CPR
guidelines and outcomes: A systematic review. Resuscitation, 162, 234–241.
3. European Resuscitation Council. (2021). European Resuscitation Council
Guidelines for Resuscitation 2021. Resuscitation, 161, 1–60.
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