Biphasic and monophasic transthoracic defibrillation in pigs with acute left ventricular dysfunction
| Autor: | Yi Zhang, Loyd R. Davies, Gudjon Karlsson, Richard E. Kerber, William J. Coddington |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Cardiac output Contraction (grammar) Heart disease Swine Defibrillation medicine.medical_treatment Electric Countershock Emergency Nursing Cardiography Impedance Random Allocation Ventricular Dysfunction Left Internal medicine Animals Medicine Cardiac Output Inhalation business.industry medicine.disease Disease Models Animal Treatment Outcome Monophasic defibrillation Anesthesia Acute Disease Anesthetics Inhalation Ventricular fibrillation Emergency Medicine Cardiology Female Halothane Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Resuscitation. 50:95-101 |
| ISSN: | 0300-9572 |
| DOI: | 10.1016/s0300-9572(01)00329-x |
| Popis: | Our purpose was to compare biphasic versus monophasic shock success for VF termination in a porcine model of acute left ventricular (LV) dysfunction.For the termination of ventricular fibrillation (VF), transthoracic biphasic waveform shocks achieve higher success rates than monophasic shocks. However, the effectiveness of biphasic versus monophasic defibrillation in a setting of left ventricular dysfunction has not been reported.In 23 open-chest adult swine (15-25 kg), LV dysfunction [or =25% decline in cardiac output (CO)] was induced by continuous inhalation of halothane (1-1.75%). Each pig randomly received transthoracic biphasic and monophasic shocks at three energy levels (30, 50 and 100 J) in two conditions: baseline and LV dysfunction. Halothane effect on left ventricular size and contraction was measured by echocardiography in three additional swine.With halothane, pigs demonstrated a decline in CO (baseline 4.16+/-0.19, halothane 2.72+/-0.19 l/min, P0.01), mean arterial pressure (baseline 107.2+/-3.5, halothane 80.1+/-3.4 mmHg, P0.01) and increased left ventricular end-diastolic pressure (baseline 6.4+/-0.9, halothane 12.7+/-0.8 mmHg, P0.01). LV diameters increased and fractional shortening fell. During baseline, biphasic shocks achieved significantly greater success (termination of VF) compared to monophasic waveforms (100 J: biphasic 83.3+/-9.5 versus monophasic 38.9+/-9.5%, P0.01; 50 J: biphasic 67.1+/-8.8 versus monophasic 11.8+/-5.7%, P0.01; 30 J: biphasic: 31.9+/-6.4 versus monophasic 0+/-0%, P0.01). The superiority of the biphasic waveform to terminate VF was retained during LV dysfunction at all energy levels (100 J: biphasic 78.3+/-7.3 versus monophasic 37.5+/-8.1%, P0.01; 50 J: biphasic 65.5+/-11.5 versus monophasic 11.7+/-5.9%, P0.01; 30 J: biphasic: 40.6+/-8.0 versus monophasic 3.1+/-3.1%, P0.01). Within both waveforms, there were no significant differences in percent shock success at any energy level comparing baseline with LV dysfunction.In this porcine model of acute LV dysfunction, biphasic waveform shocks were not only superior to monophasic waveform shocks for termination of VF during baseline, but retained superiority to monophasic waveform shocks when LV dysfunction was present. |
| Databáze: | OpenAIRE |
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