AI Article Synopsis
- Animal studies indicate that the effectiveness of double sequential external defibrillation (DSED) may depend on the timing between the two shocks, known as the "DSED interval," but this has not been tested in humans.
- A retrospective study of adult patients with refractory ventricular fibrillation (VF) explored how different DSED intervals affect outcomes like VF termination, return of spontaneous circulation (ROSC), and survival, revealing that shorter intervals (<75 ms) were linked to better outcomes.
- The study found that while shorter DSED intervals improved chances of VF termination and ROSC, there was no significant link between DSED intervals and survival to discharge or neurological status.
Article Abstract
Background: Animal studies suggest the efficacy of double sequential external defibrillation (DSED) may depend on the interval between the two shocks, or "DSED interval". No human studies have examined this concept.
Objectives: To determine the relationship between DSED interval and termination of ventricular fibrillation (VFT), return of spontaneous circulation (ROSC), survival to hospital discharge, and favourable neurological status (MRS ≤ 2) for patients in refractory VF.
Methods: We performed a retrospective review of adult (≥18 years) out-of-hospital cardiac arrest between January 2015 and May 2022 with refractory VF who received ≥1 DSED shock. DSED interval was divided into four pre-defined categories. We examined the association between DSED interval and patient outcomes using general estimated equation logistic regression or Fisher's exact test.
Results: Among 106 included patients, 303 DSED shocks were delivered (median 2, IQR 1-3). DSED intervals of 75-125 ms (OR 0.39, 95% CI 0.16-0.98), 125-500 ms (OR 0.36, 95% CI 0.16-0.82), and >500 ms (OR 0.27, 95% CI 0.11-0.63) were associated with lower probability of VF termination compared to <75 ms interval. DSED interval of >75 ms was associated with lower probability of ROSC compared to <75 ms interval (OR 0.37, 95% CI 0.14-0.98). No association was noted between DSED interval and survival to hospital discharge or neurologic outcome.
Conclusions: Among patients in refractory VF a DSED interval of less than 75 ms was associated with improved rates of VF termination and ROSC. No association was noted between DSED interval and survival to hospital discharge or neurologic outcome.
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| http://dx.doi.org/10.1016/j.resuscitation.2023.110082 | DOI Listing |
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The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest.
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Article Synopsis
- Animal studies indicate that the effectiveness of double sequential external defibrillation (DSED) may depend on the timing between the two shocks, known as the "DSED interval," but this has not been tested in humans.
- A retrospective study of adult patients with refractory ventricular fibrillation (VF) explored how different DSED intervals affect outcomes like VF termination, return of spontaneous circulation (ROSC), and survival, revealing that shorter intervals (<75 ms) were linked to better outcomes.
- The study found that while shorter DSED intervals improved chances of VF termination and ROSC, there was no significant link between DSED intervals and survival to discharge or neurological status.
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Introduction: Double sequential external defibrillation (DSED) in cardiopulmonary resuscitation has shown different results in comparison with standard defibrillation in the treatment of refractory ventricular fibrillation (RVF). This review aims to compare the advantages of DSED with standard defibrillation in the treatment of refractory ventricular fibrillation.
Materials And Methods: PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to May 1, 2022.
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