• Dong Keon Lee, Yu Jin Kim, Giwoon Kim, Choung Ah Lee, Hyung Jun Moon, Jaehoon Oh, Hae Chul Yang, Han Joo Choi, Young Taeck Oh, and Seung Min Park.
• Department of Emergency Medicine, Seoul National University Bundang Hospital, 13620, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
• Scand J Trauma Resus. 2019 Dec 10; 27 (1): 109.

BackgroundThe 2015 AHA guidelines recommend that amiodarone should be used for patients with refractory ventricular fibrillation (RVF). However, the optimal time interval between the incoming call and amiodarone administration (call-to-amiodarone administration interval) in RVF patients has not been investigated. We hypothesized that the time elapsed until amiodarone administration could affect the neurological outcome at hospital discharge in patients with RVF.Methods And ResultsThis study is a retrospective analysis of prospectively collected data. One hundred thirty-four patients were enrolled. In univariate logistic regression, the probability of a good neurological outcome at hospital discharge decreased as the time elapsed until amiodarone administration increased (OR 0.89 [95% CI = 0.80-0.99]). In multivariate logistic regression, the patients who were administered amiodarone in less than 20 min showed higher rates of prehospital ROSC, survival at hospital arrival, any ROSC, survival at admission, survival to discharge, and good CPC at hospital discharge. The call-to-amiodarone administration interval of ≤20 min (OR 6.92, 95% CI 1.72-27.80) was the independent factor affecting the neurological outcome at hospital discharge.ConclusionEarly amiodarone administration (≤ 20 min) showed better neurological outcome at hospital discharge for OHCA patients who showed initial ventricular fibrillation and subsequent RVF.

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