| Comparison of neurological outcomes following witnessed out-of-hospital ventricular fibrillation defibrillated with either biphasic or monophasic automated external defibrillators. | |
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MedLine Citation:
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PMID: 19546269 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Emergency medicine journal : EMJ Volume: 26 ISSN: 1472-0213 ISO Abbreviation: Emerg Med J Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-06-23 Completed Date: 2009-11-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100963089 Medline TA: Emerg Med J Country: England |
Other Details:
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Languages: eng Pagination: 492-6 Citation Subset: IM |
Affiliation:
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Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita 5430035, Japan. kajihanapu@yahoo.co.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cardiopulmonary Resuscitation / statistics & numerical data Cohort Studies Defibrillators* Electric Countershock / statistics & numerical data* Emergency Medical Services* Female Heart Arrest / therapy* Humans Male 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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