DEFI 2005: a randomized controlled trial of the effect of automated external defibrillator cardiopulmonary resuscitation protocol on outcome from out-of-hospital cardiac arrest
| Autor: | Daniel, Jost, Hervé, Degrange, Catherine, Verret, Olivier, Hersan, Isabelle L, Banville, Fred W, Chapman, Paula, Lank, Jean Luc, Petit, Claude, Fuilla, René, Migliani, Jean Pierre, Carpentier, Sophie, Girardeau |
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| Rok vydání: | 2010 |
| Předmět: |
Resuscitation
medicine.medical_specialty Defibrillation medicine.medical_treatment Return of spontaneous circulation law.invention Automation Random Allocation Randomized controlled trial law Physiology (medical) Internal medicine Rescue Work Medicine Humans Cardiopulmonary resuscitation Hospital Mortality Automated external defibrillator Probability business.industry Equipment Design medicine.disease Cardiopulmonary Resuscitation Heart Arrest Clinical trial Treatment Outcome Anesthesia Ventricular fibrillation Blood Circulation Multivariate Analysis Cardiology Cardiology and Cardiovascular Medicine business Software Defibrillators |
| Zdroj: | Circulation. 121(14) |
| ISSN: | 1524-4539 |
| Popis: | Background— Using automated external defibrillators (AEDs) that implement the Guidelines 2000 resuscitation protocol constrains administration of cardiopulmonary resuscitation (CPR) to Methods and Results— In a randomized controlled trial, patients with out-of-hospital cardiac arrest requiring defibrillation were treated with 1 of 2 AED protocols. In the control protocol, based on Guidelines 2000, sequences of up to 3 stacked countershocks were delivered, with rhythm analyses initially and after the first and second shocks. The study protocol featured 1 minute of CPR before the first shock, shorter CPR interruptions before and after each shock, and no stacked shocks. The primary end point was survival to hospital admission. Of 5107 out-of-hospital cardiac arrest patients connected to an AED, 1238 required defibrillation, and 845 were included in the final analysis. Study patients (n=421) had shorter preshock pauses (9 versus 19 seconds; P P P P P =0.87), survived to hospital discharge (13.3% versus 10.6%; P =0.19), achieved return of spontaneous circulation before physician arrival (47.0% versus 48.6%; P =0.65), and survived to 1 year ( P =0.77). Conclusions— Following prompts from AEDs programmed with a protocol similar to Guidelines 2005, firefighters shortened pauses in CPR and improved overall hands-on time, but survival to hospital admission of patients with ventricular fibrillation out-of-hospital cardiac arrest did not improve. Clinical Trial Registration— http://www.clinicaltrials.gov. Unique identifier: NCT00139542. |
| Databáze: | OpenAIRE |
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