Your browser doesn't support javascript.
loading
The impact of alternate defibrillation strategies on shock-refractory and recurrent ventricular fibrillation: A secondary analysis of the DOSE VF cluster randomized controlled trial.
Cheskes, Sheldon; Drennan, Ian R; Turner, Linda; Pandit, Sandeep V; Dorian, Paul.
Afiliación
  • Cheskes S; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada; Sunnybrook Research Institute and Department of Emergency Services, Sunnybrook Health Science Centre, Toronto, Ontario, Canada; Department of Family a
  • Drennan IR; Sunnybrook Research Institute and Department of Emergency Services, Sunnybrook Health Science Centre, Toronto, Ontario, Canada; Department of Family and Community Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Eva
  • Turner L; Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada.
  • Pandit SV; ZOLL Medical, Chelmsford, Massachusetts, United States.
  • Dorian P; Division of Cardiology, Unity Health, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada.
Resuscitation ; 198: 110186, 2024 May.
Article en En | MEDLINE | ID: mdl-38522736
ABSTRACT

BACKGROUND:

The DOSE VF randomized controlled trial (RCT) employed a pragmatic definition of refractory ventricular fibrillation (VF after three successive shocks). However, it remains unclear whether the underlying rhythm during the first three shocks was shock-refractory or recurrent VF.

OBJECTIVE:

To explore the relationship between alternate defibrillation strategies employed during the DOSE VF RCT and the type of VF, either shock-refractory VF or recurrent VF, on patient outcomes.

METHODS:

We performed a secondary analysis of the DOSE VF RCT. We categorized cases as shock-refractory or recurrent VF based on pre-randomization shocks (shocks 1-3). We then analyzed all subsequent (post-randomization) shocks to assess the impact of standard, vector change (VC) or double sequential external defibrillation (DSED) shocks on clinical outcomes employing logistic regression adjusted for Utstein variables, antiarrhythmics, and epinephrine.

RESULTS:

We included 345 patients; 60 (17%) shock-refractory VF, and 285 (83%) recurrent VF. Patients in recurrent VF had greater survival than shock-refractory VF (OR 2.76 95% CI [1.04, 7.27]). DSED was superior to standard defibrillation for survival overall, and for patients with shock-refractory VF (28.6% vs 0%, p = 0.041) but not for those in recurrent VF. DSED was superior to standard defibrillation for return of spontaneous circulation (ROSC) and neurologic survival for shock-refractory and recurrent VF. VC defibrillation was not superior for survival or ROSC overall, for shock-refractory, or recurrent VF groups, but was superior for VF termination across all groups.

CONCLUSION:

DSED appears to be the superior defibrillation strategy in the DOSE VF trial, irrespective of whether the preceding VF is shock-refractory or recurrent.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Fibrilación Ventricular / Cardioversión Eléctrica / Paro Cardíaco Extrahospitalario Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Resuscitation Año: 2024 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Fibrilación Ventricular / Cardioversión Eléctrica / Paro Cardíaco Extrahospitalario Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Resuscitation Año: 2024 Tipo del documento: Article Pais de publicación: Irlanda