Introduction: Refractory shockable rhythm has a high mortality rate and poor neurological outcome. Treatments for refractory shockable rhythm presenting after defibrillation and medical treatment are not definite. We conducted research on the application of double simultaneous defibrillation (DSiD) for refractory shockable rhythms.
Methods: This is a retrospective pilot study performed using medical records from 1 January 2016 to 31 December 2017. The prephase was from January to December 2016. The post-phase was from January to December 2017. During the prephase, we conducted conventional defibrillation with one defibrillator, and during the post-phase, we conducted DSiD using two defibrillators. Primary outcome was survival to hospital discharge. Secondary outcomes included survival to hospital admission and good neurological outcome at 12 months. Statistical analysis was conducted using Fisher's exact test. Data were regarded statistically significant when < 0.05.
Result: A total of 38 patients were included. Twenty-one patients underwent conventional defibrillation, and 17 underwent DSiD. The DSiD group had a higher survival to admission rate (14/17 (82.4%) vs. 6/21 (28.6%), =0.001) and showed a trend for higher survival to discharge (7/17 (41.2%) vs. 3/21 (14.3%), =0.078). Good neurological outcome at 12 months of the DSiD group was higher than that of the conventional defibrillation group, but the difference was not statistically significant (5/17 (29.4%) vs 2/21 (9.5%), =0.207).
Conclusion: In patients with refractory shockable rhythms, DSiD has increased survival to hospital admission and a trend of increased survival to hospital discharge. However, DSiD did not improve neurological outcome at 12 months.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273448 | PMC |
| http://dx.doi.org/10.1155/2020/5470912 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Signs of life are associated with a better prognosis in patients with non-shockable refractory cardiac arrest.
Am J Emerg Med
December 2024
Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. Electronic address:
Survival in relation to number of defibrillation attempts in out-of-hospital cardiac arrest.
Resuscitation
December 2024
Center for Resuscitation Science, Department of Clinical Science and Education, Södersjukhuset (KI SÖS), Karolinska Institute, Stockholm, Sweden. Electronic address:
Article Synopsis
- The study investigates the survival rates of out-of-hospital cardiac arrest (OHCA) patients with shockable rhythms in relation to the number of defibrillations they received.
- It analyzed data from 10,549 patients in Sweden over a decade, finding that survival rates decreased significantly with each additional defibrillation.
- The results indicate that patients receiving more shocks had lower 30-day survival probabilities, suggesting that after a certain point, additional defibrillations may not be beneficial.
Signs of life as a favorable predictor for non-shockable cardiac arrest undergoing extracorporeal cardiopulmonary resuscitation post non-shockable cardiac arrest.
Am J Emerg Med
January 2025
Department of Emergency Medicine, Sapporo Medical University, S1W16 Chuo-ku, Sapporo, Japan. Electronic address:
Background: When the initial rhythm of cardiac arrest is non-shockable, resuscitation outcomes tend to be unfavorable. However, signs of life (gasping, pupillary light reaction, or any form of body movement) have been suggested as favorable prognostic factors for patients with refractory cardiac arrest who are undergoing extracorporeal cardiopulmonary resuscitation (ECPR). This study determined whether signs of life are favorable neurological prognostic factors for patients undergoing ECPR post non-shockable cardiac arrest.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates how extracorporeal membrane oxygenation (ECMO) and percutaneous coronary interventions (PCI) affect the restoration of organized heart rhythms in patients experiencing out-of-hospital cardiac arrest (OHCA) with refractory shockable rhythms.
- Of 289 patients analyzed, 51% achieved an organized rhythm through advanced cardiac life support before reaching the hospital, while 30% did so after ECMO but before PCI, and only 13% did so after PCI.
- Patients with obstructive coronary artery disease had better outcomes when they achieved an organized rhythm before PCI, indicating that early effective treatment is critical for better neurological survival.
Effectiveness of Extracorporeal Cardiopulmonary Resuscitation for Non-Shockable Out-of-Hospital Cardiac Arrest: An Analysis From the SOS-KANTO 2017 Study.
Cureus
September 2024
Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kawasaki, JPN.
Article Synopsis
- ECPR using V-A ECMO can be an effective treatment for patients experiencing refractory out-of-hospital cardiac arrest (OHCA), showing promise especially in cases where CPR is initiated promptly.
- While previous studies demonstrated benefits for shockable cardiac arrests (SOHCA), the effectiveness of ECPR for non-shockable cardiac arrests (NSOHCA) was less clear prior to this research.
- The study analyzed 2,502 OHCA cases and found that those who received ECPR had significantly better survival and 90-day neurological outcomes, with quicker CPR and hospital arrival times being key factors in improving prognosis.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!