Immediate Defibrillation or Defibrillation After Cardiopulmonary Resuscitation

Koike, Soichi; Tanabe, Seizan; Ogawa, Toshio; Akahane, Manabu; Yasunaga, Hideo; Horiguchi, Hiromasa; Matsumoto, Shimpei; Imamura, Tomoaki

doi:10.3109/10903127.2011.569848

Cited by 15 publications

(4 citation statements)

References 19 publications

(25 reference statements)

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“…However, we have to keep in mind that this, and a large before-after study from Seattle 243 that showed better outcomes with 90 s of CPR before a shock when the response interval was >4 min), are from a time when 3 stacked-shocks were used and shorter periods of CPR between shocks (1 min). Evidence from five RCTs 242,[244][245][246][247] and another study 248 suggests that among unmonitored patients with OHCA and an initial rhythm of VF/pVT, there is no benefit in a period of CPR of 90-180 s before defibrillation when compared with immediate defibrillation with CPR being performed while the defibrillator equipment is being applied.…”

Section: Cpr Versus Defibrillation First For Out-of-hospital Cardiac Arrestmentioning

confidence: 99%

European Resuscitation Council Guidelines for Resuscitation 2015

et al. 2015

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These Guidelines are based on the International Liaison Committee on Resuscitation (ILCOR) 2015 Consensus on Science and Treatment Recommendations (CoSTR) for ALS. 4 The 2015 ILCOR review focused on 42 topics organised in the approximate sequence of ALS interventions: defibrillation, airway, oxygenation and ventilation, circulatory support, monitoring during CPR, and drugs during CPR. For these Guidelines the ILCOR recommendations were supplemented by focused literature reviews undertaken by the ERC ALS Writing Group for those topics not reviewed in the 2015 ILCOR CoSTR. Guidelines were drafted and agreed by the ALS Writing Group members before final approval by the ERC General Assembly and ERC Board. Summary of changes since 2010 GuidelinesThe 2015 ERC ALS Guidelines have a change in emphasis aimed at improved care and implementation of these guidelines in order to improve patient focused outcomes. 5 The 2015 ERC ALS Guidelines do not include any major changes in core ALS interventions since the previous ERC guidelines published in 2010. 1,2 The key changes since 2010 are:• Continuing emphasis on the use of rapid response systems for care of the deteriorating patient and prevention of in-hospital cardiac arrest. • Continued emphasis on minimally interrupted high-quality chest compressions throughout any ALS intervention: chest

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Section: Cpr Versus Defibrillation First For Out-of-hospital Cardiac Arrestmentioning

confidence: 99%

European Resuscitation Council Guidelines for Resuscitation 2015

et al. 2015

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“…Although patients with VF as an initial rhythm were more likely to be successfully resuscitated than with other rhythms, the less than 30% survival rate remains unsatisfactory ( Rajan et al, 2017 ). Survival from OHCA depends on a complex system working together to secure the best outcome, and early defibrillation with concurrent high-quality cardiopulmonary resuscitation (CPR) is the most important life-saving intervention for VF ( Koike et al, 2011 ). To provide a general treatment strategy, the latest guidelines for CPR and emergency cardiovascular care recommend the initiation of high-quality CPR, delivery of an electrical shock as soon as a defibrillator is available and every 2 min thereafter if VF persists ( Panchal et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Real-time amplitude spectrum area estimation during chest compression from the ECG waveform using a 1D convolutional neural network

et al. 2023

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Introduction: Amplitude spectrum area (AMSA) is a well-established measure than can predict defibrillation outcome and guiding individualized resuscitation of ventricular fibrillation (VF) patients. However, accurate AMSA can only be calculated during cardiopulmonary resuscitation (CPR) pause due to artifacts produced by chest compression (CC). In this study, we developed a real-time AMSA estimation algorithm using a convolutional neural network (CNN).Methods: Data were collected from 698 patients, and the AMSA calculated from the uncorrupted signals served as the true value for both uncorrupted and the adjacent corrupted signals. An architecture consisting of a 6-layer 1D CNN and 3 fully connected layers was developed for AMSA estimation. A 5-fold cross-validation procedure was used to train, validate and optimize the algorithm. An independent testing set comprised of simulated data, real-life CC corrupted data, and preshock data was used to evaluate the performance.Results: The mean absolute error, root mean square error, percentage root mean square difference and correlation coefficient were 2.182/1.951 mVHz, 2.957/2.574 mVHz, 22.887/28.649% and 0.804/0.888 for simulated and real-life testing data, respectively. The area under the receiver operating characteristic curve regarding predicting defibrillation success was 0.835, which was comparable to that of 0.849 using the true value of the AMSA.Conclusions: AMSA can be accurately estimated during uninterrupted CPR using the proposed method.

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“…18 Since October 2006, CPR has been based on the respective 2005 guidelines. 13,19 Do-not-resuscitate orders or living wills are not generally accepted, and EMS personnel are not allowed to terminate or withhold resuscitation out of hospital. Therefore, most patients who have an OHCA who are treated by EMS personnel are transported to hospital, excluding those with decapitation, incineration, decomposition, rigor mortis, or dependent cyanosis.…”

Section: Ems System In Japanmentioning

confidence: 99%

Comparison of Outcomes After Use of Biphasic or Monophasic Defibrillators Among Out-of-Hospital Cardiac Arrest Patients

Tanabe

Yasunaga

Ogawa

et al. 2012

Circ: Cardiovascular Quality and Outcomes

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Background— The use and popularity of the biphasic waveform defibrillator as a replacement for the monophasic waveform defibrillator are increasing, but it is unclear whether this can improve the rate of survival among out-of-hospital cardiac arrest patients. This study aimed to verify the hypothesis that the outcome of out-of-hospital cardiac arrest patients who received defibrillation shock with the biphasic waveform defibrillator was better than that of patients who received defibrillation shock with the monophasic defibrillator. Methods and Results— This prospective, nationwide, population-based, observational study included 21 172 out-of-hospital cardiac arrest patients with initial ventricular fibrillation or pulseless ventricular tachycardia from January 1, 2005, through December 31, 2007. Defibrillation shock was performed by monophasic defibrillator on 8224 (39%) patients and by biphasic defibrillator on 12 948 (61%) patients. The rate of survival at 1 month with minimal neurological impairment was 11.6% (951/8192) in the monophasic defibrillator group and 12.8% (1653/12 928) in the biphasic defibrillator group. Hierarchical logistic regression analysis using a generalized estimation equation showed no significant difference between the biphasic and monophasic groups in 1-month survival with minimal neurological impairment (adjusted odds ratio, 1.07; 95% confidence interval, 0.91–1.26; P =0.42). Confirmatory propensity score analyses showed similar results. Conclusions— Although monophasic defibrillators are being replaced by biphasic defibrillators, our nationwide population-based observational study failed to demonstrate a statistically significant association between defibrillation waveform and 1-month survival rate with minimal neurological impairment.

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Immediate Defibrillation or Defibrillation After Cardiopulmonary Resuscitation

Cited by 15 publications

References 19 publications

European Resuscitation Council Guidelines for Resuscitation 2015

European Resuscitation Council Guidelines for Resuscitation 2015

Real-time amplitude spectrum area estimation during chest compression from the ECG waveform using a 1D convolutional neural network

Comparison of Outcomes After Use of Biphasic or Monophasic Defibrillators Among Out-of-Hospital Cardiac Arrest Patients

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