Survival rates following cardiac arrest went up 300% when emergency responders used Cardiocerebral Resuscitation, a new resuscitation approach for cardiac arrest pioneered at The University of Arizona Sarver Heart Center. Because the new technique does away with mouth-to-mouth breathing, it enhances the willingness to perform resuscitation in lay individuals.

"In out-of-hospital cardiac arrest, the brain and the heart need resuscitation, not the lungs," said Gordon A. Ewy, director of UA Sarver Heart Center, where the new approach was developed. Ewy is one of few people in the world named a "CPR Giant" by the American Heart Association.

In CPR according to current AHA guidelines, 30 chest compressions are delivered, followed by two mouth-to-mouth breaths. While the responder presses on the chest, oxygenated blood is moved through the body and delivered to the organs.

"But when you stop chest compressions to give mouth-to-mouth ventilations, no blood is moved and the organs essentially are starved," Ewy said. "In fact, during CPR, blood flow to the brain and the organs is so poor that stopping chest compression for any reason - including so called 'rescue breathing' - is not helpful."

At the American Heart Association's 2006 Scientific Sessions in Chicago, Ewy presented data from Emergency Medical Services in the Phoenix Metropolitan Area showing that 9% of out-of-hospital cardiac arrest victims survived after the implementation of Cardiocerebral Resuscitation. This equals a 300% increase compared to the time when first responders used guideline CPR, resulting in a mere 3% survival rate.

As a cause of death, out-of-hospital cardiac arrest is second only to all cancer deaths combined, taking the lives of 490,000 Americans every year. Despite periodic updates in the CPR guidelines, survival rates following out-of-hospital cardiac arrest have remained dismal over the past 20 years, hovering between 1 and 3% in most large cities in the United States. Survival rates are better only if an automated external defibrillator (AED) is available and is used soon after the cardiac arrest.

"We think CPR is not optimal because it is advocated as a 'one-size-fits-all' approach, ignoring that cardiac arrest and respiratory arrest are two distinct pathophysiological conditions," said Ewy. "Ventilations are necessary in cases of respiratory arrest, such as near-drowning accidents or drug overdose."