• Resuscitation · Sep 2002

    Body weight is a predictor of biphasic shock success for low energy transthoracic defibrillation.

    • Yi Zhang, Craig B Clark, L Ray Davies, Gudjon Karlsson, Zimmerman M Bridget MB, and Richard Kerber.
    • Department of Internal Medicine, Division of Cardiovascular Diseases, The Cardiovascular Center, The University of Iowa and Clinics, 200 Hawkins Drive, 52242, Iowa City, IA, USA.
    • Resuscitation. 2002 Sep 1; 54 (3): 281-7.

    BackgroundTransthoracic impedance and current flow are determinants of defibrillation success with monophasic shocks. Whether transthoracic impedance, either independently or via its association with body weight, is a determinant of biphasic waveform shock success has not been determined.Methods And ResultsWe studied 22 swine, weighing 18-41 kg. After 15 s of ventricular fibrillation, each pig received transthoracic truncated exponential biphasic shocks (5/5 ms), 70-360 J. Shock success was strongly associated individually with body weight, leading-edge transthoracic impedance and current at low energy levels (70 and 100 J, all P<0.001). Multiple logistic regression analysis showed a significant association of body weight with shock success after adjusting for the effect of leading-edge impedance (odds ratio of success for 1 kg decrease in weight at 70 J was 1.29, 95% CI: 1.05-1.59, P=0.02; and at 100 J was 1.30, 95% CI: 1.14-1.49, P<0.0001). The same result was observed after adjusting for the effect of leading-edge current. At 150 J or higher energy levels, no significant association was observed.ConclusionsBody weight is a determinant of shock success with biphasic waveforms at low energy levels in this swine model.

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