Incidence and outcomes of out-of-hospital cardiac arrest with shock-resistant ventricular fibrillation: Data from a large population-based cohort

Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: Conventional cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation

“…[15][16][17] Although the survival rate of ventricular fibrillation following C-CPR improved from 15.4% in 1998 to 20.4% in 2006, neurological outcomes following refractory ventricular fibrillation have remained largely unchanged (from 7.7% to 5.6%) over the past decade. 6 In contrast, we demonstrated particularly good neurological outcomes (40%) in those receiving E-CPR, which suggests that the addition of ECMO support may be a helpful tool in patients with refractory ventricular fibrillation. The management of prolonged cardiac arrest due to refractory ventricular fibrillation is a clinical challenge.…”

“…All patients received repeat defibrillation attempts and high doses of epinephrine and amiodarone, and the overall survival rate of 35% was higher than that previously reported. 6 The study showed a trend toward a higher rate of survival in the E-CPR group compared with the C-CPR group (50% vs 27.5%, p = 0.1512). We also found a significantly higher rate of sustained ROSC/ROSB in the E-CPR group compared with that in the C-CPR group, despite the higher frequency of defibrillation and the higher doses of epinephrine in the E-CPR group.…”

“…4,5 Indeed, the reported survival rate is 20.4% in this scenario, with only 5.6% of patients regaining good neurological outcomes in out of hospital arrest. 6 A previous study suggests that using extracorporeal membrane oxygenation (ECMO) in extracorporeal CPR (E-CPR) can improve the clinical outcomes in patients with prolonged cardiac arrest beyond 10 min. 4 However, the cost of ECMO is high and the patient characteristics that are likely to gain most from ECMO have not been established.…”

Dual defibrillation in out-of-hospital cardiac arrest: A retrospective cohort analysis

“…The age-adjusted annual incidence of refractory VF is estimated to be between 0.5 and 0.6 cases per 100,000 people. 7 Due to its rarity and lack of a standard definition, there are no currently established best practices for this difficult to treat condition. Double sequential defibrillation (DSD) is postulated to be a solution to the dilemma of recurrent/refractory VF and pulseless VT. 8 In DSD, the "double" refers to the use of two separate defibrillators on the same patient; "sequential" refers to the administration of nearly simultaneous defibrillations from both devices.…”

Actual treatments for out‐of‐hospital ventricular fibrillation at critical care medical centers in Osaka: a pilot descriptive study

“…3 We also suggested that the transportation of OHCA patients to the critical care medical centers (CCMCs) was associated with better outcomes after OHCA. 4 Some reports suggested the effectiveness of extracorporeal life support (ELS) usage before return of spontaneous circulation (ROSC), 5,6 and in-hospital post-arrest care such as therapeutic hypothermia (TH) 7,8 and percutaneous coronary intervention (PCI) 9 to improve the outcome after OHCA.…”