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Survival in ventricular fibrillation with emphasis on the number of defibrillations in relation to other factors at resuscitation.
Sahlgrenska University Hospital.
Karolinska Institutet.
Karolinska Institutet.
Sistema Emergències Mèdiques de Catalunya.
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2017 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 113, p. 33-38, article id S0300-9572(17)30017-5Article in journal (Refereed) Published
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Abstract [en]

INTRODUCTION: Mortality after out of hospital cardiac arrest (OHCA) is high and a shockable rhythm is a key predictor of survival. A concomitant need for repeated shocks appears to be associated with less favorable outcome.

AIM: To, among patients found in ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) describe: (a) factors associated with 30-day survival with emphasis on the number of defibrillatory shocks delivered; (b) the distribution of and the characteristics of patients in relation to the number of defibrillatory shocks that were delivered.

METHODS: Patients who were reported to The Swedish Register for Cardiopulmonary Resuscitation (SRCR) between January 1 1990 and December 31 2015 and who were found in VF/pVT took part in the survey.

RESULTS: In all there were 19,519 patients found in VF/pVT. The 30-day survival decreased with an increasing number of shocks among all patients regardless of witnessed status and regardless of time period in the survey. In a multivariate analysis there were 12 factors that were associated with the chance of 30-day survival one of which was the number of shocks that was delivered. For each shock that was added the chance of survival decreased. Factors associated with an increased 30-day survival included CPR before arrival of EMS, female sex, cardiac etiology and year of OHCA (increasing survival over years). Factors associated with a decreased chance of 30-day survival included: increasing age, OHCA at home, the use of adrenaline and intubation and an increased delay to CPR, defibrillation and EMS arrival.

CONCLUSION: Among patients found in VF/pVT, 7.5% required more than 10 shocks. For each shock that was added the chance of 30-day survival decreased. There was an increase in 30-day survival over time regardless of the number of shocks. On top of the number of defibrillations, eleven further factors were associated with 30-day survival.

Place, publisher, year, edition, pages
2017. Vol. 113, p. 33-38, article id S0300-9572(17)30017-5
Keywords [en]
Cardiac arrest, Defibrillation, Number of defibrillations, Resuscitation, Survival in out of hospital cardiac arrest, Ventricular fibrillation
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:hb:diva-13345DOI: 10.1016/j.resuscitation.2017.01.006ISI: 000400455200023PubMedID: 28109996Scopus ID: 2-s2.0-85012206943OAI: oai:DiVA.org:hb-13345DiVA, id: diva2:1170719
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2018-01-04Bibliographically approved

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Herlitz, JohanAxelsson, Christer

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