Survival to hospital discharge with biphasic fixed 360 joules versus 200 escalating to 360 joules defibrillation strategies in out-of-hospital cardiac arrest of presumed cardiac etiology
| Autor: | E. Brooke Lerner, David Persse, Michael Lozano, Mikkel T. Steinberg, Lars Wik, Pierre M. van Grunsven, Jan-Aage Olsen, Fritz Sterz, Mark Westfall, Cathrine Brunborg |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Resuscitation Emergency Medical Services Non-Randomized Controlled Trials as Topic Defibrillation medicine.medical_treatment Electric Countershock 030204 cardiovascular system & hematology Emergency Nursing Out of hospital cardiac arrest Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Hospital discharge Humans Cardiopulmonary resuscitation Aged business.industry 030208 emergency & critical care medicine Middle Aged medicine.disease Cardiopulmonary Resuscitation Patient Discharge Shock (circulatory) Ventricular fibrillation Practice Guidelines as Topic Ventricular Fibrillation Emergency Medicine Cardiology Etiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest |
| Zdroj: | Resuscitation. 136 |
| ISSN: | 1873-1570 |
| Popis: | Introduction Guidelines recommend constant or escalating energy levels for shocks after the initial defibrillation attempt. Studies comparing survival to hospital discharge with escalating vs fixed high energy level shocks are lacking. We compared survival to hospital discharge for 200 J escalating to 360 J vs fixed 360 J in patients with initial ventricular fibrillation/pulseless ventricular tachycardia in a post-hoc analysis of the Circulation Improving Resuscitation Care trial database. Methods and Results Pre-shock rhythm, rhythm 5 s after shock, shock energy levels, termination of ventricular fibrillation/pulseless ventricular tachycardia (TOF), and survival to hospital discharge were recorded. Association between defibrillation strategy and survival to hospital discharge was investigated with multivariable logistic regression. The escalating energy group included 260 patients and 883 shocks vs 478 patients and 1736 shocks in the fixed-high energy group. There was no difference in survival to hospital discharge between escalating (70/255 patients, 28%) and fixed energy group (132/478 patients, 28%) (unadjusted OR 1.00, 95% CI 0.72–1.42 and adjusted OR 0.81, 95% CI 0.54–1.22, p = 0.32). First shock TOF was 86% in the escalating group compared to 83% in the fixed-high group, p = 0.27. Conclusion There was no difference in survival to hospital discharge or the frequency of TOF between escalating energy and fixed-high energy group. ClinicalTrials.gov Identifier: NCT00597207. |
| Databáze: | OpenAIRE |
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