Human Electrical Muscular Incapacitation and Effects on QTc Interval

Gibbons, John A.; Mojica, Andrew J.; Peele, Mark E.

doi:10.1111/1556-4029.13490

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…Independently of the general quality of the included studies, findings were categorized based on the possible risk of methodologic bias (Table 1 and Table 2). Table 1 presents information on the 11 included studies that were found to have a lower possible risk of bias.…”

Section: Resultsmentioning

confidence: 99%

Human Health Risks of Conducted Electrical Weapon Exposure

et al. 2021

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IMPORTANCE Conducted electrical weapons (CEWs) are used broadly as a less-lethal force option for police officers. However, there is no clear picture of the possible health risks in humans on the basis of rigorously assessed scientific evidence from the international peer-reviewed literature. OBJECTIVE To synthesize and systematically evaluate the strength of published evidence for an association between exposure to different models of CEWs and adverse acute as well as chronic conditions. EVIDENCE REVIEW Following a preregistered review protocol, the literature search strategy was based on a search of reviews published between January 1, 2000, and April 24, 2020, of PubMed, MEDLINE, EMBASE, Web of Science, PsycINFO, and Cochrane Library, as well as relevant online databases and bibliographic sources, such as reference sections of recent publications. The identified studies were independently assessed in terms of scope, relevance, methodologic bias, and quality. Peer-reviewed publications of human studies were included, using original data and with a focus on the use of taser CEWs in the context of law enforcement. Eligible studies examined clearly defined health outcomes as dependent variables following exposure to a CEW. The review followed the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. A meta-analysis could not be conducted. FINDINGS Of the 1081 unique records screened, 33 relevant studies were identified, all of them of experimental design and conducted in the US. Eleven studies had a low risk of bias and 22 had a higher bias risk. Studies focused on outcomes such as physiologic stress responses, heart rate, blood pressure, arrhythmias, or cognitive performance. Independently of bias risk, the studies reported few or no acute health problems, apart from the wounds caused by the darts. Furthermore, no longterm outcomes were studied. Most of the studies were performed on healthy, physically fit individuals (eg, police officers) in a controlled setting, with short exposure duration (5 seconds). Half of the studies, mainly those with a higher risk of bias, were at least partly funded by the manufacturer. CONCLUSIONS AND RELEVANCE Based on the findings of the reviewed studies, the risk for adverse health outcomes due to CEW exposure can be currently estimated as low. However, most of the reviewed studies had methodologic limitations. Considering that recruited participants were not representative of the population that usually encounters a CEW deployment, it is not possible to draw conclusions regarding exposure outcomes in potentially vulnerable populations or high-risk groups, such as those under the influence of substances.

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Section: Resultsmentioning

confidence: 99%

Human Health Risks of Conducted Electrical Weapon Exposure

et al. 2021

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“…25 Moreover, the QTc interval is still mainly used to analyse the risk of arrhythmia associated with specific drugs or procedures. 26,27 Second, the small sample size of this study could be a limitation. However, the post-hoc power analysis showed a power of 0.987 when using the mean value of the QTc interval before anaesthetic induction and 90 minutes after pneumoperitoneum.…”

Section: Discussionmentioning

confidence: 97%

Effects of long periods of pneumoperitoneum combined with the head-up position on heart rate-corrected QT interval during robotic gastrectomy: an observational study

et al. 2018

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ObjectivePneumoperitoneum and the head-up position reportedly stimulate the sympathetic nervous system, potentially increasing the risk of cardiac arrhythmia. We evaluated the effects of a long duration of pneumoperitoneum in the head-up position on the heart rate-corrected QT (QTc) interval during robotic gastrectomy.MethodsThis prospective observational study involved 28 patients undergoing robotic gastrectomy. The QTc interval was recorded at the following time points: before anaesthetic induction (baseline); 10 minutes after tracheal intubation; 1, 5, 30, 60, and 90 minutes after pneumoperitoneum induction in the head-up position; after pneumoperitoneum desufflation in the supine position; and at the end of surgery. The primary outcome was the QTc interval, which was measured 90 minutes after pneumoperitoneum combined with the head-up position.ResultsCompared with baseline, the QTc interval was significantly prolonged at 1 and 60 minutes after pneumoperitoneum, peaked at 90 minutes, and was sustained and notably prolonged until the end of surgery. However, no considerable haemodynamic changes developed.ConclusionA long period of carbon dioxide pneumoperitoneum application in a head-up position significantly prolonged the QTc interval during robotic gastrectomy. Therefore, diligent care and close monitoring are required for patients who are susceptible to developing ventricular arrhythmia.Trial Registration: Registered at ClinicalTrials.gov; https://clinicaltrials.gov/ct2/show/NCT02604979; Registration number NCT02604979

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“…Drs. Luceri, Kroll, Calkins, and Halperin pose many questions about the present paper . Several of these questions were answered in the reply to Drs.…”

Section: Descriptive Statistics and Inferential Test Of Means For Thementioning

confidence: 92%