Verkaik, Bas J;
Stieglis, Remy;
Tan, Hanno;
van Schuppen, Hans;
Koster, Rudolph W;
van der Werf, Christian
Abstract 420: The Association Between Ventricular Fibrillation Duration and Successful Termination After the First Shock in Witnessed Out-of-Hospital Cardiac Arrest Patients
Sie können Bookmarks mittels Listen verwalten, loggen Sie sich dafür bitte in Ihr SLUB Benutzerkonto ein.
Medientyp:
E-Artikel
Titel:
Abstract 420: The Association Between Ventricular Fibrillation Duration and Successful Termination After the First Shock in Witnessed Out-of-Hospital Cardiac Arrest Patients
Beteiligte:
Verkaik, Bas J;
Stieglis, Remy;
Tan, Hanno;
van Schuppen, Hans;
Koster, Rudolph W;
van der Werf, Christian
Beschreibung:
Introduction: In OHCA patients with an initial shockable rhythm, a longer time interval between onset of VF and the first shock decreases the likelihood of survival. The exact mechanism to explain this decrease is not clear. We investigated the time interval between delay to the first shock and outcomes VF termination, return of organized rhythm (ROOR), ROSC and survival. Methods: We studied witnessed OHCA patients with VF as an initial rhythm using the prospective ARREST registry. Patient- and resuscitation data, including time-synchronized AED and manual defibrillator data, were analysed to determine VF termination at 5 seconds after the first shock. Shock delay was defined as the time from initial emergency call till first shock by any defibrillator. Outcomes were rates of termination of VF, ROOR 5 seconds after the first shock, ROSC before transport, and survival to discharge, all in relation to the delay to the first shock. A logistic regression corrected for age, sex and basic life support before EMS arrival was used to analyse the association between VF duration and outcomes. Results: A total of 3676 cases were analysed. VF termination rates declined from 95% when the first shock was delivered <2 minutes after the call to 75% when delivered after >16 minutes (Figure 1). Rates of ROOR (49% to 23%), ROSC before transport (86% to 33%), and survival to discharge (79% to 23%) all declined significantly. Every additional minute in VF was associated with a 9% increased odds of failure to terminate VF (OR 1.09 [95% CI 1.07-1.12]), a 7% reduced odds of ROOR (OR 0.93 [95% CI 0.91-0.95]), a 12% reduced odds of acquiring ROSC before transport (OR 0.88 [95% CI 0.86-0.90]), and a 15% reduced odds of surviving to discharge (OR 0.85 [95% CI 0.83-0.87]). Conclusions: Every additional minute of delay to the first shock was associated with significant decreases in rates of VF termination, ROOR, and ROSC during transportation. This may explain the worse outcomes in patients with a long delay to defibrillation.