Acute cardiac care & resuscitationCohort study

Decline in rescue breathing and its impact on outcomes in pediatric out-of-hospital cardiac arrest due to drowning: a nationwide study, 2012–2023

ResuscitationPublished

  • nationwide study
  • All-Japan Utstein Registry (2012-2023)
  • multivariable Poisson regression

Authors' conclusion

In pediatric drowning OHCA, CO-CPR was associated with worse survival and neurological outcomes than RB-CPR. These findings underscore the necessity for rescue breathing and the importance of ventilation-focused bystander CPR training in pediatric and drowning-related scenarios.

Study context

Population
Pediatric OHCA patients (≤17 years old) whose arrests were caused by drowning and received bystander CPR from laypersons
Participants
740 eligible patients
Exposure
Compression-only CPR (CO-CPR) compared with rescue-breathing CPR (RB-CPR)
Outcome
30-day mortality
Follow-up
30 days

Main finding

As reported in the abstract

Adjusted relative risk

1.38

95% CI 1.14–1.67

CO-CPR vs RB-CPR
aRR 1.38 (95% CI 1.14–1.67)

Observational data: associations, not effects.

Secondary outcomes

Bystander CPR type

Bystander CPR type

The proportion of RB-CPR declined over the study period

Prehospital absence of return of spontaneous circulation (ROSC) and 30-day unfavorable neurological survival (secondary)

CO-CPR associated with higher prehospital absence of ROSC and worse neurological outcomes compared with RB-CPR

By witnessed status (subgroup)

Adverse association of CO-CPR most pronounced in unwitnessed arrests

Original publication

Decline in rescue breathing and its impact on outcomes in pediatric out-of-hospital cardiac arrest due to drowning: a nationwide study, 2012–2023. Resuscitation. Published 10 March 2026. doi:10.1016/j.resuscitation.2026.111049

Summarised from the published abstract; every number is checked against it