TY - JOUR
T1 - Determinants of defibrillation
T2 - Prospective analysis of 183 patients
AU - Kerber, Richard E.
AU - Jensen, Susan R.
AU - Gascho, Joseph
AU - Grayzel, Joseph
AU - Hoyt, Robert
AU - Kennedy, Jeffrey
N1 - Funding Information:
From the Cardiovascular Center, the Department of Medicine, and the CPR Committee, University of Iowa Hospital, Iowa City, Iowa. This study was supported in part by Chnt HL-14388 from the National Heart, Lung, and Blood Institute, the National Institutes of Health, Bethesda, Maryland, and by a grant from the Datascope Corporation, Paramus, New Jersey. Manuscript received February 9, 1983; revised manuscript received June 6, 1983, accepted June 9, 1983. Address for reprints: Richard E. Kerber, MD, DepaWnent of Medicine, University of Iowa Hospital, Iowa City, Iowa 52242.
PY - 1983/10/1
Y1 - 1983/10/1
N2 - Previous studies have suggested that a number of factors may influence the ability to defibrillate: the transthoracic resistance and resultant current flow, the paddle electrode size, the duration of preshock ventricular fibrillation (VF) and cardiopulmonary resuscitation, metabolic abnormalities, body weight, the shock energy selected, and whether the patient is receiving lidocaine. To examine the effect of these variables, a prospective study was conducted of 183 patients who received direct-current shocks for VF. Overall defibrillation rates approached 90%, even in patients with secondary VF, but rates of successful resuscitation and survival were much lower. Patients who never defibrillated despite multiple shocks had a prolonged duration of cardiopulmonary resuscitation preceding the first shock (21 ± 14 minutes) and systemic hypoxia and acidosis. These conditions tended to occur in patients who initially had cardiac arrest from causes other than VF: asystole, severe bradycardia and electromechanical dissociation. In such patients, VF developed only as a late event, which was then often unresponsive to attempted defibrillation. The other factors examined were not major determinants of defibrillation.
AB - Previous studies have suggested that a number of factors may influence the ability to defibrillate: the transthoracic resistance and resultant current flow, the paddle electrode size, the duration of preshock ventricular fibrillation (VF) and cardiopulmonary resuscitation, metabolic abnormalities, body weight, the shock energy selected, and whether the patient is receiving lidocaine. To examine the effect of these variables, a prospective study was conducted of 183 patients who received direct-current shocks for VF. Overall defibrillation rates approached 90%, even in patients with secondary VF, but rates of successful resuscitation and survival were much lower. Patients who never defibrillated despite multiple shocks had a prolonged duration of cardiopulmonary resuscitation preceding the first shock (21 ± 14 minutes) and systemic hypoxia and acidosis. These conditions tended to occur in patients who initially had cardiac arrest from causes other than VF: asystole, severe bradycardia and electromechanical dissociation. In such patients, VF developed only as a late event, which was then often unresponsive to attempted defibrillation. The other factors examined were not major determinants of defibrillation.
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U2 - 10.1016/0002-9149(83)90408-3
DO - 10.1016/0002-9149(83)90408-3
M3 - Article
C2 - 6624665
AN - SCOPUS:0020512068
SN - 0002-9149
VL - 52
SP - 739
EP - 745
JO - The American journal of cardiology
JF - The American journal of cardiology
IS - 7
ER -