A favorable neurological outcome is closely related to patient characteristics and total cardiopulmonary resuscitation (CPR) duration.

The total CPR duration consists of pre-hospital and in-hospital durations.

To date, consensus is lacking on the optimal total CPR duration. Therefore, this study aimed to determine the upper limit of total CPR duration, the optimal cut-off time at the pre-hospital level, and the time to switch from conventional CPR to alternative CPR such as extracorporeal CPR.

Among 7,914 patients with out-of-hospital cardiac arrest (OHCA), 577 had favorable neurological outcomes.

The optimal cut-off for pre-hospital CPR duration in patients with OHCA was 12 min regardless of the initial rhythm.

Although there is an upper limit of CPR duration, favorable neurological outcomes can be expected according to each patient’s resuscitation-related factors, despite prolonged CPR duration.

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