Kiss of life on heart attack victims 'does more harm than good'

PUBLISHED : Saturday, 17 March, 2007, 12:00am
UPDATED : Saturday, 17 March, 2007, 12:00am

Forget mouth-to-mouth when giving first aid to a heart attack victim - it does more harm than good, a landmark study has found.

The chances of surviving a heart attack outside a hospital double if a bystander performs chest-compressions but omits mouth-to-mouth resuscitation, which is widely regarded as part of standard rescue procedure, according to the study published yesterday in British medical journal The Lancet.

Not only was there 'no evidence for any benefit from the addition of mouth-to-mouth ventilation' during cardio-pulmonary resuscitation (CPR), the chances of surviving with a 'favourable neurological outcome' were twice as high when would-be rescuers focused exclusively on trying to revive the heart by rhythmic chest-compressions, wrote Ken Nagao, who led the study of more than 4,000 heart attack cases in Japan. Dr Nagao is chief of emergency and critical care medicine at Surugadai Nihon University Hospital in Tokyo.

In a commentary, Gordon Ewy, director of the University of Arizona's Sarver Heart Centre wrote: 'This finding ... should lead to a prompt interim revision of the guidelines for out-of-hospital cardiac arrest.'

The purpose of pushing air into a heart attack victim's lungs is to oxygenate the blood, while the massaging the chest aims to restart the heart or re-establish a regular heartbeat.

But this first large-scale comparison of survival rates of cardiac arrest patients belied the standard CPR technique, which has been taught to millions of people around the world, Dr Ewy said.

'We have found that the survival rate is higher even when the blood has less oxygen content but is moved through the body by continuous chest compressions,' he said.

If results of the Japanese study are used to revise the standard guidelines for helping victims before medical professionals arrive at the scene, it could have another positive effect: more people might be willing to try.

Of the 4,068 adults examined who had heart attacks witnessed by strangers, 439 received cardiac-only resuscitation and 712 were given conventional CPR.

But 2,917 - more than 70 per cent - were left to fend for themselves.