Amiodarone as Compared with Lidocaine for Shock-Resistant Ventricular Fibrillation

Dorian, Paul; Cass, Dan; Schwartz, Brian; Cooper, Richard; Gelaznikas, Robert; Barr, Aiala

doi:10.1056/nejmoa013029

Cited by 691 publications

(339 citation statements)

References 14 publications

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“…For the important outcome of survival to hospital admission, there was very-low-quality evidence (downgraded for risk of bias, indirectness, and imprecision) from 1 RCT in adult OHCA 63 showing improved survival to hospital admission with intravenous amiodarone compared with intravenous lidocaine (OR, 2.17; 95% CI, 1.21-3.83; P=0.009).…”

Section: Consensus On Sciencementioning

confidence: 99%

“…For the important outcome of ROSC, there was very-lowquality evidence (downgraded for risk of bias, imprecision, indirectness, and possible publication bias) from 1 observational cohort study of pediatric IHCA 62 For the important outcome of survival to hospital admission, there was very-low-quality evidence (downgraded for risk of bias, indirectness, and imprecision) from 1 RCT in adult OHCA 63 showing improved survival to hospital admission with intravenous amiodarone compared with intravenous lidocaine (OR, 2.17; 95% CI, 1.21-3.83; P=0.009).…”

Section: Consensus On Sciencementioning

confidence: 99%

See 1 more Smart Citation

Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support

Caen¹,

Maconochie²,

Aickin³

et al. 2015

Circulation

152

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The Pediatric Task Force reviewed all questions submitted by the International Liaison Committee on Resuscitation (ILCOR) member councils in 2010, reviewed all council training materials and resuscitation guidelines and algorithms, and conferred on recent areas of interest and controversy. We identified a few areas where there were key differences in council-specific guidelines based on historical recommendations, such as the A-B-C (Airway, Breathing, Circulation) versus C-A-B (Circulation, Airway, Breathing) sequence of provision of cardiopulmonary resuscitation (CPR), initial back blows versus abdominal thrusts for foreign-body airway obstruction, an upper limit for recommended chest compression rate, and initial defibrillation dose for shockable rhythms (2 versus 4 J/kg). We produced a working list of prioritized questions and topics, which was adjusted with the advent of new research evidence. This led to a prioritized palate of 21 PICO (population, intervention, comparator, outcome) questions for ILCOR task force focus.The 2015 process was supported by information specialists who performed in-depth systematic searches, liaising with pediatric content experts so that the most appropriate terms and outcomes and the most relevant publications were identified. Relevant adult literature was considered (extrapolated) in those PICO questions that overlapped with other task forces, or when there were insufficient pediatric data. In rare circumstances (in the absence of sufficient human data), appropriate animal studies were incorporated into reviews of the literature. However, these data were considered only when higher levels of evidence were not available and the topic was deemed critical.When formulating the PICO questions, the task force felt it important to evaluate patient outcomes that extend beyond return of spontaneous circulation (ROSC) or discharge from the pediatric intensive care unit (PICU). In recognition that the measures must have meaning, not only to clinicians but also to parents and caregivers, longer-term outcomes at 30 days, 60 days, 180 days, and 1 year with favorable neurologic status were included in the relevant PICO questions.Each task force performed a detailed systematic review based on the recommendations of the Institute of Medicine of the National Academies 1 and using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) working group.2 After identifying and prioritizing the questions to be addressed (by using the PICO format) 3 with the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evaluation. The reviewers for each question created a reconciled risk-of-bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 4 Quality Assessment of Diagnosti...

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Section: Consensus On Sciencementioning

confidence: 99%

Section: Consensus On Sciencementioning

confidence: 99%

Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support

Caen¹,

Maconochie²,

Aickin³

et al. 2015

Circulation

152

View full text Add to dashboard Cite

show abstract

“…As discussed previously, amiodarone was compared to lidocaine in the treatment of out-of-hospital ventricular fibrillation in the ALIVE trial and found to lead to substantially higher rates of survival to hospital admission [36].…”

Section: Class III Antiarrhythmic Medications Amiodaronementioning

confidence: 99%

“…In a randomized trial, ALIVE, comparing lidocaine to amiodarone as an adjunct to defibrillation in patients with out of hospital cardiac arrest, there was significantly increased surivial to hospital admission with amiodarone when compared to lidocaine (23% vs. 12%) [36], Ohshige et al looked at use of lidocaine and epinephrine vs. epinephrine alone in patients with VF who experienced out of hospital cardiac arrest and found improved survival to discharge [37]. A similar study also found the use of lidocaine to improve chance of survival to hospitalization after out of hospital cardiac arrest with VF (38% vs. 18%), however, they did not find an improvement in survival until discharge.…”

Section: Class Ib Antiarrhythmic Medications Lidocainementioning

confidence: 99%

Antiarrhythmic Medications for Cardioversion and Maintenance of Sinus Rhythm in Patients with Cardiac Arrhythmias: A Review of the Literature

En¹,

Sk²

2017

Cardiovasc Pharm Open Access

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Introduction: Cardiac arrhythmias, including supraventricular and ventricular tachycardias, portend a higher risk of morbidity and mortality. These arrhythmias also are associated with increased healthcare resource utilization, decreased quality of life, and increased activity impairment. Pharmacologic conversion is a treatment option for conversion to sinus rhythm that has the advantage of avoiding sedation from DC cardioversion.

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“…For the important outcome of ROSC, there was very-low-quality evidence (downgraded for risk of bias, imprecision, indirectness, and possible publication bias) from 1 observational cohort study of pediatric IHCA 62 For the important outcome of survival to hospital admission, there was verylow-quality evidence (downgraded for risk of bias, indirectness, and imprecision) from 1 RCT in adult OHCA 63 showing improved survival to hospital admission with intravenous amiodarone compared with intravenous lidocaine (OR, 2.17; 95% CI, 1.21-3.83; P50.009).…”

Section: Consensus On Sciencementioning

confidence: 99%