| Autor: |
Elizabeth Perry, Emily Nehme, Dion Stub, David Anderson, Ziad Nehme |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
Resuscitation Plus, Vol 14, Iss , Pp 100405- (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2666-5204 |
| DOI: |
10.1016/j.resplu.2023.100405 |
| Popis: |
Aim: To examine the impact of time to amiodarone administration on survival from shock-refractory Ventricular Fibrillation/pulseless Ventricular Tachycardia (VF/pVT) following out-of-hospital cardiac arrest (OHCA). Methods: A retrospective cohort study of adult (≥16 years) OHCA patients in shock-refractory VF/pVT (after 3 consecutive defibrillation attempts) of medical aetiology who arrested between January 2010 and December 2019. Time-dependent propensity score matching was used to sequentially match patients who received amiodarone at any given minute of resuscitation with patients eligible to receive amiodarone during the same minute. Log-binomial regression models were used to assess the association between time of amiodarone administration (by quartiles of time-to-matching) and survival outcomes. Results: A total of 2,026 patients were included, 1,393 (68.8%) of whom received amiodarone with a median (interquartile range) time to administration of 22.0 (18.0–27.0) minutes. Propensity score matching yielded 1,360 matched pairs. Amiodarone administration within 28 minutes of the emergency call was associated with a higher likelihood of return of spontaneous circulation (ROSC) (≤18minutes: RR = 1.03 (95%CI 1.02, 1.04); 19-22minutes: RR = 1.02 (95%CI 1.01, 1.03); 23-27minutes: RR = 1.01 (95%CI 1.00, 1.02)) and event survival (pulse on hospital arrival) (≤18 minutes: RR = 1.05 (95%CI 1.03, 1.07); 19–22 minutes: RR = 1.03 (95%CI 1.01, 1.05); 23–27 minutes: RR = 1.02 (95%CI 1.00, 1.03). Amiodarone administration within 23 minutes of the emergency call was associated with a higher likelihood of survival to hospital discharge (≤18minutes: RR = 1.17 (95%CI 1.09, 1.24; 19–22 minutes: RR = 1.10 (95%CI 1.04, 1.17). Conclusion: Amiodarone administered within 23 minutes of the emergency call is associated with improved survival outcomes in shock-refractory VF/pVT, although prospective trials are required to confirm these findings. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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