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 Citations (Scopus)

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

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Ventricular Fibrillation
Defibrillators
Shock
Thorax
Swine
Nervous System
Hand

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Nursing(all)

Cite this

Immediate post-shock chest compressions improve outcome from prolonged ventricular fibrillation. / Berg, Robert A.; Hilwig, Ronald W.; Berg, Marc D; Berg, David D.; Samson, Ricardo A; Indik, Julia H; Kern, Karl B.

In: Resuscitation, Vol. 78, No. 1, 07.2008, p. 71-76.

Research output: Contribution to journalArticle

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AU - Indik, Julia H

AU - Kern, Karl B

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N2 - 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.

AB - 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.

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KW - Ventricular fibrillation

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