Immediate post-shock chest compressions improve outcome from prolonged ventricular fibrillation

RESUSCITATION

卷:78

Article

Berg, Robert A.^1,2  Hilwig, Ronald W.¹  Berg, Marc D.^1,2  Berg, David D.¹  Samson, Ricardo A.^1,2  Indik, Julia H.¹  Kern, Karl B.¹ 

[1] Univ Arizona, Coll Med, Sarver Heart Ctr, Tucson, AZ 85724 USA

[2] Univ Arizona, Steele Childrens Res Ctr, Tucson, AZ 85724 USA

关键词: chest compressions;    cardiac arrests;    ventricular fibrillation;    defibrillation;    cardiopulmonary resuscitation;    heart arrest;    automated external defibrillator (AED);    outcome;   

DOI  :  10.1016/j.resuscitation.2008.02.014

来源: Elsevier

【 摘 要 】

Aim: This study was designed to test the hypothesis that immediate post-shock chest compressions improve outcome from prolonged ventricular fibrillation (VF) compared with typical hands off period (i.e., delayed post-shock compressions) associated with AED use. Materials and methods: After 7.5 min of untreated VF, 36 domestic swine (26 1 kg) were treated with 200 J biphasic shocks and randomly assigned to: (1) 1 min of immediate post-shock chest compressions or (2) simulated pre-hospital automated external defibrillator (AED) care with delays in post-shock chest compressions. Return of spontaneous circulation (ROSC) occurred in 7/18 immediate chest compressions animals within 2 min of the first shock versus 0/18 AED animals (P < 0.01). Ten of 18 immediate chest compressions animals attained ROSC compared with 3/18 AED animals (P < 0.05). Nine of 18 immediate chest compressions swine were alive at 24 and 48 h compared with 3/18 AED swine (P < 0.05). All 48-h survivors had good neurologic outcomes. Among the 21 animals that defibrillated with the first shock, ROSC was attained in 7/10 immediate chest compressions animals within 2 min of the first shock compared with 0/11 AED animals (P = 0.001), and 48-h survival was attained in 8/10 versus 3/11, respectively (P < 0.05). Conclusions: Immediate post-shock chest compressions can substantially improve outcome from prolonged VF compared with simulated pre-hospital AED care. (c) 2008 Elsevier Ireland Ltd. All. rights reserved.

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