[Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Baskıdaki Makaleler: TARD-58067

The number of prehospital defibrillation shocks and return of spontaneous circulation in out-of-hospital cardiac arrest

Romain Jouffroy, Perrine Ravasse, Anastasia Saade, Rado Idialisoa, Pascal Philippe, Pierre Carli, Benoit Vivien
Service d’anesthésie réanimation - SAMU - Hôpital Necker-Enfants malades - APHP - 149 rue de Sèvres 75015 Paris - France

Objective: Whether the number of defibrillation shocks delivered over the first 30 minutes of cardiopulmonary resuscitation (CPR) impacts on the rate of successful return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) has not been determined yet.
Methods: We conducted a retrospective observational study in non-traumatic OHCA. Patients who were administered defibrillation shocks with a public automated external defibrillator (AED) were consecutively enrolled in the study. We assessed the relationship between ROSC and the number of prehospital defibrillation shocks, and constructed a ROC curve to illustrate the ability of repeated defibrillation shocks to predict ROSC over the first 30 minutes of CPR.
Results: Increasing the number of defibrillation shocks progressively decreased the probability to achieve ROSC. The highest rate of ROSC (33%) was observed when four shocks were delivered. The ROC curve illustrated that the 4th shock maximized sensitivity and specificity (AUC=0.72). The positive and negative predictive values for ROSC reached 82% and 48% respectively, when less than 4 shocks were delivered.
Conclusion: The delivery of 4 defibrillation shocks in OHCA most related to ROSC. Evaluation of the number of delivered shock during the first 30 minutes of CPR is a simple tool that can be used for early decision in OHCA patient.

Keywords: Number of defibrillation shocks, Shockable rhythm, Out-of-hospital cardiac arrest, Resuscitation, Outcome.

Sorumlu Yazar: Romain Jouffroy, France

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