• Resuscitation · Jan 2009

    Comparative Study

    Progressing from initial non-shockable rhythms to a shockable rhythm is associated with improved outcome after out-of-hospital cardiac arrest.

    • Theresa M Olasveengen, Martin Samdal, Petter Andreas Steen, Lars Wik, and Kjetil Sunde.
    • Institute for Experimental Medical Research, Ulleval University Hospital, N-0407 Oslo, Norway. t.m.olasveengen@medisin.uio.no
    • Resuscitation. 2009 Jan 1;80(1):24-9.

    BackgroundCardiac arrest patients with initial non-shockable rhythm progressing to shockable rhythm have been reported to have inferior outcome to those remaining non-shockable. We wanted to confirm this observation in our prospectively collected database, and assess whether differences in cardiopulmonary resuscitation (CPR) quality could help to explain any such difference in outcome.Materials And MethodsAll out-of-hospital cardiac arrest (OHCA) cases in the Oslo EMS between May 2003 and April 2008 were retrospectively studied, and cases with initial asystole or pulseless electrical activity (PEA) were selected. Pre-hospital and hospital records, Utstein forms, and continuous ECGs were reviewed. Quality of CPR and outcome were compared for patients who progressed to a shockable rhythm and patients who remained in non-shockable rhythms.ResultsOf 753 cases with initial non-shockable rhythms 517 (69%) had asystole and 236 (31%) PEA. Ninety-eight (13%) patients progressed to a shockable rhythm, while 653 (87%) remained non-shockable during the entire resuscitation effort (two unknown). Hands-off ratio was higher in the shockable than the non-shockable group, 0.21+/-0.12 vs. 0.16+/-0.10 (p=0.000) with no significant difference in compression and ventilation rates. Overall survival to hospital discharge was 3%; 7% in the shockable and 2% in the non-shockable group (p=0.014). Based on a multivariate logistic analysis young age, initial PEA, and progressing to a shockable rhythm were associated with better outcome.ConclusionProgressing from initial non-shockable rhythms to a shockable rhythm was associated with improved outcome after OHCA. This occurred despite more pauses in chest compressions in the shockable group, probably related to defibrillation attempts.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…