Immediate post-shock chest compressions improve outcome from prolonged ventricular fibrillation

Robert A. Berg, Ronald W. Hilwig, Marc D. Berg, David D. Berg, Ricardo A. Samson, Julia H. Indik, Karl B. Kern

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Aim: This study was designed to test the hypothesis that immediate post-shock chest compressions improve outcome from prolonged ventricular fibrillation (VF) compared with typical "hands off" period (i.e., delayed post-shock compressions) associated with AED use. Materials and methods: After 7.5 min of untreated VF, 36 domestic swine (26 ± 1 kg) were treated with 200 J biphasic shocks and randomly assigned to: (1) 1 min of immediate post-shock chest compressions or (2) simulated pre-hospital automated external defibrillator (AED) care with delays in post-shock chest compressions. Return of spontaneous circulation (ROSC) occurred in 7/18 immediate chest compressions animals within 2 min of the first shock versus 0/18 AED animals (P < 0.01). Ten of 18 immediate chest compressions animals attained ROSC compared with 3/18 AED animals (P < 0.05). Nine of 18 immediate chest compressions swine were alive at 24 and 48 h compared with 3/18 AED swine (P < 0.05). All 48-h survivors had good neurologic outcomes. Among the 21 animals that defibrillated with the first shock, ROSC was attained in 7/10 immediate chest compressions animals within 2 min of the first shock compared with 0/11 AED animals (P = 0.001), and 48-h survival was attained in 8/10 versus 3/11, respectively (P < 0.05). Conclusions: Immediate post-shock chest compressions can substantially improve outcome from prolonged VF compared with simulated pre-hospital AED care.

Original languageEnglish (US)
Pages (from-to)71-76
Number of pages6
JournalResuscitation
Volume78
Issue number1
DOIs
StatePublished - Jul 2008

Keywords

  • Automated external defibrillator (AED)
  • Cardiac arrests
  • Cardiopulmonary resuscitation
  • Chest compressions
  • Defibrillation
  • Heart arrest
  • Outcome
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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