Document Detail

Comparison of neurological outcomes following witnessed out-of-hospital ventricular fibrillation defibrillated with either biphasic or monophasic automated external defibrillators.
MedLine Citation:
PMID:  19546269     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Biphasic waveform defibrillation results in higher rates of termination of fibrillation than monophasic waveform defibrillation but has not been shown to improve survival outcomes. OBJECTIVE: To compare the effectiveness of a biphasic automated external defibrillator (AED) with a monophasic AED for witnessed out-of-hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF). METHODS: In a prospective population-based cohort study, adults with witnessed VF OHCA were treated with either monophasic or biphasic waveform AED shocks. The primary outcome measure was neurologically favourable 1-month survival, defined as a Cerebral Performance Categories score of 1 or 2. RESULTS: Of 366 adults with witnessed OHCA of presumed cardiac aetiology, 74 (20%) had VF. Termination of VF with the first shock tended to occur more frequently after biphasic AED shocks (36/44 (82%) vs 20/30 (67%), p = 0.14). Return of spontaneous circulation (ROSC) occurred more frequently after biphasic AED shocks (29/44 (66%) vs 8/30 (27%), p = 0.001). Neurologically favourable 1-month survival was also more frequent in the biphasic group (10/44 (23%) vs 1/30 (3%), p = 0.04). The median time interval from the first shock to the second shock was 67 s in the monophasic group and 24 s in the biphasic group (p = 0.001). CONCLUSIONS: Treatment with biphasic AED shocks improved the likelihood of ROSC and neurologically favourable 1-month survival after witnessed VF compared with monophasic AED shocks. In addition to waveform differences, a shorter time interval from the first shock to the second shock could account for the better outcomes with biphasic AED.
K Kajino; T Iwami; R A Berg; A Hiraide; Y Hayashi; H Yukioka; H Tanaka; T Shimazu; H Sugimoto
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  26     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-23     Completed Date:  2009-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  492-6     Citation Subset:  IM    
Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita 5430035, Japan.
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MeSH Terms
Cardiopulmonary Resuscitation / statistics & numerical data
Cohort Studies
Electric Countershock / statistics & numerical data*
Emergency Medical Services*
Heart Arrest / therapy*
Middle Aged
Nervous System Diseases / etiology*
Prospective Studies
Treatment Outcome
Ventricular Fibrillation / therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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