Transthoracic Defibrillation Using Sequential and Simultaneous Dual Shock Pathways: Experimental Studies
| Autor: | Bruce Pritchard, Richard E. Kerber, Michael J. Kallok, Joe D. Bourland, Francis Charbonnier, Pamela Hite, Karen Fox‐Eastham, Robert A. Kieso, Clay A. Birkett |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
medicine.medical_specialty
Time Factors Defibrillation Single shock medicine.medical_treatment Electric Countershock Blood Pressure Energy requirement Dogs Heart Rate Internal medicine medicine Animals Waveform Electrodes Dual pathway Pulse (signal processing) business.industry Electric Conductivity General Medicine Surgery Sinusoidal waveform Shock (circulatory) Ventricular Fibrillation Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Pacing and Clinical Electrophysiology. 13:207-217 |
| ISSN: | 1540-8159 0147-8389 |
| DOI: | 10.1111/j.1540-8159.1990.tb05071.x |
| Popis: | Dual pathway sequential DC shocks reduce energy requirements for internal defibrillation. Our purpose was to determine if dual pathway shocks similarly reduce energy requirements or improve shock success in transthoracic (external) defibrillation. We studied 39 closed-chest anesthetized mongrel dogs. The dual pathways used were left chest to right chest and left chest to posterior. In eight dogs we also assessed dual shock pathways oriented orthogonally, left lower chest to right upper chest and left upper chest to right lower chest. Four different dual pathway groups were studied: group 1: simultaneous shocks, sinusoidal waveform; group 2: sequential shocks, sinusoidal waveform, 100-msec shock separation, orthogonal shock pathways; group 3: sequential shocks, sinusoidal waveform, 100 msec shock separation; and group 4: sequential shocks, rectangular waveform (sequential shocks: 2 pulses, 2.5 msec each, 0.1-msec separation; single shock: 1 pulse, 5 msec). Shocks were given at 50 (J) joules, 100 J and 150 J and curves of energy versus success compared for dual pathway shocks versus single shocks. We found that the highest mean success rates (96 +/- SD 9%) were achieved by simultaneous sinusoidal waveform dual pathway shocks at 100 J; this was identical to results achieved by the single pathway sinusoidal waveform comparison shocks at 100 J. Sequential dual pathway sinusoidal shocks separated by 100 msec achieved a mean success rate of 79 +/- 31% at 150 J; the comparison single pathway mean success rate was similar: 81 +/- 22% at 150 J. Thus, dual pathway sequential or simultaneous transthoracic shocks did not demonstrate clear superiority over single pathway shocks. |
| Databáze: | OpenAIRE |
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