当前位置： SCI文献检索 > RESUSCITATION期刊下所有文献 > Analysis of amplitude spectral area and slope to predict defibrillation in out of hospital cardiac arrest due to ventricular fibrillation (VF) according to VF type: recurrent versus shock-resistant.

Analysis of amplitude spectral area and slope to predict defibrillation in out of hospital cardiac arrest due to ventricular fibrillation (VF) according to VF type: recurrent versus shock-resistant.

Abstract：

BACKGROUND:In out-of-hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF), VF may recur during resuscitation (recurrent VF) or fail to defibrillate (shock-resistant VF). While retrospective studies have suggested that amplitude spectral area (AMSA) and slope predict defibrillation, it is unknown whether the predictive power is influenced by VF type. We hypothesized that in witnessed OHCA with initial rhythm of VF that the utility for AMSA and slope to predict defibrillation would differ between shock-resistant and recurrent VF. METHODS:AMSA and slope were measured immediately prior to each shock. For second or later shocks, VF was classified as recurrent or shock-resistant. Cardiac arrest was classified according to whether the majority of shocks were for recurrent VF or shock-resistant VF. RESULTS:44 patients received 98 shocks for recurrent VF and 96 shocks for shock-resistant VF; 24 patients achieved ROSC in the field. AMSA and slope were higher in recurrent VF compared to shock-resistant VF (AMSA: 28.8±13.1 vs 15.2±8.6 mVHz, P<0.001, and slope: 2.9±1.4 vs 1.4±1.0 mVs(-1), P=0.001). Recurrent VF was more likely to defibrillate than shock-resistant VF (P<0.001). AMSA and slope predicted defibrillation in shock-resistant VF (P<0.001 for both AMSA and slope) but not in recurrent VF. Recurrent VF predominated in 79% of patients that achieved ROSC compared to 55% that did not (P=0.10). CONCLUSIONS:In witnessed OHCA with VF as initial rhythm, recurrent VF is associated with higher values of AMSA and slope and is likely to re-defibrillate. However, when VF is shock-resistant, AMSA and slope are highly predictive of defibrillation.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Shanmugasundaram M,Valles A,Kellum MJ,Ewy GA,Indik JH

doi

10.1016/j.resuscitation.2012.02.008

subject

Has Abstract

pub_date

2012-10-01 00:00:00

pages

1242-7

issue

10

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(12)00103-7

journal_volume

83

pub_type

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