Influence of physical fitness on the performance of 5-minute continuous chest compression

Objective: Inadequate chest compressions during cardiopulmonary resuscitation (CPR) may be insufficient to provide the required blood flow to preserve critical organ function. The purpose of this study was to evaluate the influence of the CPR provider's physical fitness on the quality of chest compression and physiological changes during continuous chest compressions for 5 min. We also investigated the possible effects of rescuer's sex, weight, and height on the quality of CPR performed. Methods: Forty-seven participants performed uninterrupted chest compressions on a manikin for 5 min. Before performing CPR, the physical fitness of every candidate was assessed using common measures of physical fitness, including maximal aerobic exercise capacity, muscle strength, muscle power, muscle endurance, and reactive agility. To evaluate the physical strain, we monitored the ratings of perceived exertion score, heart rate, minute ventilation volume, volume of carbon dioxide production per minute, and volume of oxygen consumption per minute during CPR performance. Results: There was a significant reduction in the percentage of correct compressions after the first minute: 78.8% in the first, 57.2% in the second, 43.4% in the third, 36.5% in the fourth, and 28.0% in the fifth minute (P<0.001). We observed good correlations between the numbers of correct compressions with muscle strength at each minute except the first minute. In multiple regression analyses, only muscle strength affects the quality of correct chest compression (R=49.4%, P<0.05). Conclusion: The results of this study suggest that a fitness program, such as muscle strength exercise for CPR providers, should be considered for improving survival from cardiac arrest.