Dual defibrillation in out-of-hospital cardiac arrest: A retrospective cohort analysis

Autor: David A. Wampler, David A. Miramontes, Stephen A. Harper, Theodore T. Redman, Elliot M. Ross, Julian G. Mapp
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Emergency Medical Services
Time Factors
Databases
Factual
Defibrillation
medicine.medical_treatment
Electric Countershock
030204 cardiovascular system & hematology
Emergency Nursing
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Emergency medical services
Humans
Cardiopulmonary resuscitation
Prospective Studies
Prospective cohort study
Survival analysis
Retrospective Studies
business.industry
Case-control study
030208 emergency & critical care medicine
Retrospective cohort study
Middle Aged
medicine.disease
Survival Analysis
Cardiopulmonary Resuscitation
Case-Control Studies
Ventricular fibrillation
Ventricular Fibrillation
Emergency Medicine
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Out-of-Hospital Cardiac Arrest
Defibrillators
Zdroj: Resuscitation. 106
ISSN: 1873-1570
Popis: Study objectives The goal of our study is to determine if prehospital dual defibrillation (DD) is associated with better neurologically intact survival in out-of-hospital cardiac arrest. Methods This study is a retrospective cohort analysis of prospectively collected Quality Assurance/Quality Improvement data from a large urban fire based EMS system out-of-hospital cardiac arrest (OHCA) database between Jan 2013 and Dec 2015. Our inclusion criteria were administration of DD or at least four conventional 200J defibrillations for cases of recurrent and refractory ventricular fibrillation (VF). We excluded any case with incomplete data. The primary outcome for our study was neurologically intact survival (defined as Cerebral Performance Category 1 and 2). Results A total of 3470 cases of OHCA were treated during the time period of Jan 2013 to Dec 2015. There were 302 cases of recurrent and refractory VF identified. Twenty-three cases had incomplete data. Of the remaining 279 cases, 50 were treated with DD and 229 received standard single shock 200J defibrillations. There was no statistically significant difference in the primary outcome of neurologically intact survival between the DD group (6%) and the standard defibrillation group (11.4%) ( p =0.317) (OR 0.50, 95% CI 0.15–1.72). Conclusion Our retrospective cohort analysis on the prehospital use of DD in OHCA found no association with neurologically intact survival. Case–control studies are needed to further evaluate the efficacy of DD in the prehospital setting.
Databáze: OpenAIRE
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