Document Detail


Evaluation of biphasic transthoracic defibrillation in an animal model of prolonged ventricular fibrillation.
MedLine Citation:
PMID:  10490248     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine whether a biphasic defibrillation waveform (BDW) would produce a superior rate of converting prolonged ventricular fibrillation (VF) into a perfusing rhythm and delay the occurrence of asystole and/or pulseless electrical activity (PEA) during the resuscitation attempt, when compared with a monophasic defibrillation waveform (MDW). METHODS: The authors performed a prospective, randomized, blinded experiment using an established swine model of prolonged VF. Thirty-four mixed-breed domestic swine (mean mass 22.9 kg) were sedated (ketamine/xylazine), anesthetized (isoflurane), and intubated. Aortic and femoral venous catheters were placed. ECG was monitored continuously. The animals were shocked into VF (3-s, 100-mA, 60-Hz shock), and were untreated for 8 minutes. Advanced Cardiac Life Support (ACLS) began with 1 minute of standardized (Thumper) chest compressions and ventilation. The animals were randomized to treatment with either BDW or MDW. Standard ACLS protocols were followed. The energy sequence was 2.5 J/kg first, 3.5 J/kg second, and 4.5 J/kg for all subsequent shocks. Outcome variables were time to event of asystole/PEA, return of spontaneous circulation (ROSC), and one-hour survival. Data were analyzed with two-tailed Fisher's exact test and Kaplan-Meier survival plots (alpha = 0.05). RESULTS: ROSC occurred more frequently in the BDW group (7/17) compared with the MDW group (1/17); p = 0.04. Survival analysis showed that the BDW significantly delayed the occurrence of asystole/PEA during the resuscitation attempt when compared with the MDW; log-ranked p = 0.02. One-hour survival rates (5/17 BDW and 1/17 MDW, p = 0.17) did not differ. CONCLUSIONS: BDW resulted in a superior rate of ROSC and delay in the occurrence of asystole/ PEA during the resuscitation attempt when compared with MDW.
Authors:
M D Scheatzle; J J Menegazzi; T L Allen; S B Durham
Related Documents :
24576858 - Effects of altered airway function on exercise ventilation in asthmatic adults.
25072488 - Planning and executing complex large-scale exercises.
2376078 - Increasing fibrillation duration enhances relative asymmetrical biphasic versus monopha...
10642128 - Improved efficacy of anodal biphasic defibrillation shocks following a failed defibrill...
17315458 - Inhalation anesthesia in dumeril's monitor (varanus dumerili) with isoflurane, sevoflur...
16738448 - Aerobic exercise and lipids and lipoproteins in patients with cardiovascular disease: a...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  6     ISSN:  1069-6563     ISO Abbreviation:  Acad Emerg Med     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-10-28     Completed Date:  1999-10-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  880-6     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Allegheny General Hospital, MCP-Hahnemann University, School of Medicine, Pittsburgh, PA 15212, USA. mscheatz@aherf.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Disease Models, Animal
Electric Countershock / methods*
Evaluation Studies as Topic
Female
Male
Random Allocation
Sensitivity and Specificity
Survival Analysis
Survival Rate
Swine
Time Factors
Ventricular Fibrillation / mortality,  therapy*

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


Previous Document:  Antioxidant effects of isoflavonoids and lignans, and protection against DNA oxidation.
Next Document:  Emergency department observation of poisoned patients: how long is necessary?