Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with refractory ventricular fibrillation

Driver, Brian E.; Debaty, Guillaume; Plummer, David; Smith, Stephen W.

doi:10.1016/j.resuscitation.2014.06.032

Cited by 66 publications

(56 citation statements)

References 16 publications

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“…14 A few case reports have illustrated successful beta-blocker use in patients with refractory ventricular fibrillation. 19 Hassan et al, 20 have tried magnesium sulfate, but showed similar survival rates of 4% compared to 2% for conventional therapy. Harayama et al, 21 reported 28% and 18% rates of survival to discharge with nifekalant and amiodarone, respectively.…”

Section: Discussionmentioning

confidence: 99%

Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: Conventional cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: Conventional cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation

et al. 2015

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“…The guidelines also make reference to considering the reversible causes, known as the 5 H’s and T’s (hypovolemia, hypoxia, hydrogen ion [acidosis], hyper-/hypokalemia, hypothermia, toxins, tamponade (cardiac), tension pneumothorax, coronary thrombosis and pulmonary thrombosis) 4. The case presented goes beyond these guidelines, and may be described as a refractory case of VF secondary to electrical storm 5–6. The current case failed to respond to this standard approach to therapy.…”

Section: Discussionmentioning

confidence: 99%

“…In the setting of cardiac arrest, the patient not only has a swell of endogenous catecholamines, but is also receiving exogenous epinephrine every 3–5 minutes 6. Several studies report on survival with positive neurological outcome through the use of standard class III antiarrhythmics with subsequent administration of short-acting beta blockers 6–7, 11–12…”

Section: Discussionmentioning

confidence: 99%

First Report of Survival in Refractory Ventricular Fibrillation After Dual-Axis De brillation and Esmolol Administration

Boehm

Keyes

Mader

et al. 2016

WestJEM

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There is a subset of patients who suffer a witnessed ventricular fibrillation (VF) arrest and despite receiving reasonable care with medications (epinephrine and amiodarone) and multiple defibrillations (3+ attempts at 200 joules of biphasic current) remain in refractory VF (RVF), also known as electrical storm. The mortality for these patients is as high as 97%. We present the case of a patient who, with a novel approach, survived RVF to outpatient follow up.

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“…The Minnesota Resuscitation Consortium has implemented a management strategy of mechanical cardiopulmonary resuscitation (CPR) facilitated transport, extracorporeal membrane oxygenation (ECMO), and primary coronary intervention (PCI) . Alternatively, some emergency medical services (EMS) systems are using prehospital beta‐blockers based on limited emergency department (ED) data . Another proposed management strategy is the prehospital use of double sequential defibrillation (DSD).…”

Section: Importancementioning

confidence: 99%

Prehospital Double Sequential Defibrillation: A Matched Case–Control Study

Mapp

Hans

Darrington

et al. 2019

Academic Emergency Medicine

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Objectives: The goal of our study was to determine whether prehospital double sequential defibrillation (DSD) is associated with improved survival to hospital admission in the setting of refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT).Methods: This project is a matched case-control study derived from prospectively collected quality assurance/ quality improvement data obtained from the San Antonio Fire Department out-of-hospital cardiac arrest (OHCA) database between January 2013 and December 2015. The cases were defined as OHCA patients with refractory VF/pVT who survived to hospital admission. The control group was defined as OHCA patients with refractory VF/ pVT who did not survive to hospital admission. The primary variable in our study was prehospital DSD. The primary outcome of our study was survival to hospital admission.Results: Of 3,469 consecutive OHCA patients during the study period, 205 OHCA patients met the inclusion criterion of refractory VF/pVT. Using a predefined algorithm, two blinded researchers identified 64 unique cases and matched them with 64 unique controls. Survival to hospital admission occurred in 48.0% of DSD patients and 50.5% of the conventional therapy patients (p > 0.99; odds ratio = 0.91, 95% confidence interval = 0.40-2.1).Conclusion: Our matched case-control study on the prehospital use of DSD for refractory VF/pVT found no evidence of associated improvement in survival to hospital admission. Our current protocol of considering prehospital DSD after the third conventional defibrillation in OHCA is ineffective.

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Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with refractory ventricular fibrillation

Cited by 66 publications

References 16 publications

Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: Conventional cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation

Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: Conventional cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation

First Report of Survival in Refractory Ventricular Fibrillation After Dual-Axis De brillation and Esmolol Administration

Prehospital Double Sequential Defibrillation: A Matched Case–Control Study

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