Pre-shock chest compression pause effects on termination of ventricular fibrillation/tachycardia and return of organized rhythm within mechanical and manual cardiopulmonary resuscitation

Olsen, Jan-Aage; Brunborg, Cathrine; Steinberg, Mikkel; Persse, David; Sterz, Fritz; Lozano, Michael; Westfall, Mark; Travis, David T.; Lerner, E. Brooke; Brouwer, Marc A.; Wik, Lars

doi:10.1016/j.resuscitation.2015.04.023

Cited by 22 publications

(13 citation statements)

References 36 publications

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“…For each shock, we determined VF termination outcome, defined as the absence of VF for at least 5 seconds after the shock. 14,18,19 For analysis of the probability of VF termination, we excluded shocks for which the preshock no-compression interval could not be measured in full.…”

Section: Discussionmentioning

confidence: 99%

“…In 223 OHCA patients, Kramer-Johansen et al 6 compared defibrillation using manual and AED mode and found a significant difference in preshock pause duration (15 versus 22 seconds) but no difference in VF termination rate (61% versus 60%), despite a higher rate of postshock pulse-generating rhythms in the manual defibrillation arm (7% versus 3%). In an analysis of 912 patients enrolled in the Circulation Improving Resuscitation Care (CIRC) trial, Olsen et al 18 found no association between preshock pause duration and VF termination rate during manual CPR and a significant positive association during mechanical CPR, with VF termination rate increasing as preshock pause duration increased.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Association Between Chest Compression Interruptions and Clinical Outcomes of Ventricular Fibrillation Out-of-Hospital Cardiac Arrest

Brouwer

Walker²,

Chapman³

et al. 2015

Circulation

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Background-Minimizing pauses in chest compressions during cardiopulmonary resuscitation is a focus of current guidelines. Prior analyses found that prolonged pauses for defibrillation (perishock pauses) are associated with worse survival. We analyzed resuscitations to characterize the association between pauses for all reasons and both ventricular fibrillation termination and patient survival. Methods and Results-In 319 patients with ventricular tachycardia/fibrillation out-of-hospital cardiac arrest, we analyzed recordings from all defibrillators used during resuscitation and measured durations of all cardiopulmonary resuscitation pauses. Median durations were 32 seconds (25th and 75th percentile, 22 and 52 seconds) for the longest pause for any reason, 23 seconds (25th and 75th percentile, 14 and 34 seconds) for the longest perishock pause, and 24 seconds (25th and 75th percentile, 11 and 38 seconds) for the longest nonshock pause. Multivariable regression models showed lower odds for survival per 5-second increase in the longest overall pause (odds ratio, 0.89; 95% confidence interval, 0.83-0.95), longest perishock pause (odds ratio, 0.85; 95% confidence interval, 0.77-0.93), and longest nonshock pause (odds ratio, 0.83; 95% confidence interval, 0.75-0.91). In 36% of cases, the longest pause was a nonshock pause; this subgroup had lower survival than the group in whom the longest pause was a perishock pause (27% versus 44%, respectively; P<0.01) despite a higher chest compression fraction. Preshock pauses were 8 seconds (25th and 75th percentile, 4 and 17 seconds) for shocks that terminated ventricular fibrillation and 7 seconds (25th and 75th percentile, 4 and 13 seconds) for shocks that did not (P=0.18). Conclusions-Prolonged pauses have a negative association with survival not explained by chest compression fraction or decreased ventricular fibrillation termination rate. Ventricular fibrillation termination was not the mechanism linking pause duration and survival. Strategies shortening the longest pauses may improve outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association Between Chest Compression Interruptions and Clinical Outcomes of Ventricular Fibrillation Out-of-Hospital Cardiac Arrest

Brouwer

Walker²,

Chapman³

et al. 2015

Circulation

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“…This was studied in a secondary analysis where TOF success rate was compared between shocks delivered in a chest compression pause and shocks delivered during chest compressions (zero chest compression pause). (175) This study identified that shocks with zero chest compression pause achieved lower TOF compared with those delivered after a chest compression pause of various lengths (1-9 sec: 26 %, 10-19 sec: 15 %, 20-29 sec: 7 % and above 30 sec: 5 %, Chi squared, first shock: 77 % TOF, p=0.05). (175) These results go against most studies regarding pre-shock pauses (123,125,126,128,129) and might indicate that defibrillation during chest compressions may be suboptimal.…”

Section: Mechanical Chest Compressionsmentioning

confidence: 90%

Minimizing pre-shock chest compression pauses in a cardiopulmonary resuscitation cycle by performing an earlier rhythm analysis

et al. 2015

Self Cite

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“…Shortening pre-/post-defibrillation pauses of chest compression increases 13-fold chance of ROSC [38]. Besides, decrease pre-defibrillation pause of chest compression increases chance of successful defibrillation and effects of termination ventricular tachycardia (VT)/ventricular fibrillation (VF) situation [39]. Even now, a safe and effective tool for "handson" defibrillation solves chest compression interruption of pre-/post-defibrillation pause and increases chance of successful defibrillation.…”

Section: Minimalize Chest Compression Interruptionsmentioning

confidence: 99%

Chest Compression-Only Cardiopulmonary Resuscitation

Chen¹,

Lin²

2017

Resuscitation Aspects

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The survival rate of out-of-cardiac arrest (OHCA) was very low, which was mainly due to the victims who do not receive cardiopulmonary resuscitation (CPR) immediately. It was estimated that if people who quickly get chest compression-only CPR while awaiting medical treatment have double or even triple the chance of surviving. In the true world, many individuals are unwilling to do mouth-to-mouth breathing due to fear of infections or unable to do mouth-to-mouth breathing at the same time in the situation of only one bystander. This article has performed an extensive review in order to update the concept of chest compression-only CPR.

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Pre-shock chest compression pause effects on termination of ventricular fibrillation/tachycardia and return of organized rhythm within mechanical and manual cardiopulmonary resuscitation

Cited by 22 publications

References 36 publications

Association Between Chest Compression Interruptions and Clinical Outcomes of Ventricular Fibrillation Out-of-Hospital Cardiac Arrest

Association Between Chest Compression Interruptions and Clinical Outcomes of Ventricular Fibrillation Out-of-Hospital Cardiac Arrest

Minimizing pre-shock chest compression pauses in a cardiopulmonary resuscitation cycle by performing an earlier rhythm analysis

Chest Compression-Only Cardiopulmonary Resuscitation

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