Is low voltage ventricular fibrillation still a diagnostic problem?

Małysz, Marek; Kacprzak, Piotr

doi:10.5603/demj.2019.0007

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…Out-of-hospital cardiac arrest (OHCA) remains a major public health problem [1], especially in the emergency medical service (EMS) teams, where staff, due to limited personnel, are often forced to choose which procedure to follow first [2]. As Gräsner et al [3] indicates, the prevalence of OHCA is 40 cases per 100,000 adults.…”

Section: Introductionmentioning

confidence: 99%

Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study

Borkowska¹,

Smereka

Safiejko³

et al. 2021

Cardiol J.

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Background: Out-of-hospital cardiac arrest (OHCA) is a challenge for medical personnel, especially in the current COVID-19 pandemic, where medical personnel should perform resuscitation wearing full personal protective equipment. This study aims were to assess the characteristics and outcomes of adults who suffered an out-of-hospital cardiac arrest in the COVID-19 pandemic treated by emergency medical service (EMS) teams. Methods: All EMS-attended OHCA adults over than 18 years in the Polish EMS registry were analyzed. The retrospective EMS database was conducted. EMS interventions performed between March 1, and April 30, 2020 were retrospectively screened. Results: In the study period EMS operated 527 times for OHCA cases. The average age of patients with OHCA was 67.8 years. Statistically significantly more frequently men were involved (64.3%). 298 (56.6%) of all OHCA patients had resuscitation attempted by EMS providers. Among resuscitated patients, 73.8% were cardiac etiology. 9.4% of patients had return of spontaneous circulation, 27.2% of patients were admitted to hospital with ongoing chest compression. In the case of 63.4% cardiopulmonary resuscitation was ineffective and death was determined. Conclusions: The present study found that OHCA incidence rate in the Masovian population (central region of Poland) in March-April 2020 period was 12.2/100,000 adult inhabitants. Return of spontaneous circulation in EMS was observed only in 9.4% of resuscitated patients. The presence of shockable rhythms was associated with better prognosis. The prehospital mortality, even though it was high, did not differ from those reported by other studies.

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Section: Introductionmentioning

confidence: 99%

Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study

Borkowska¹,

Smereka

Safiejko³

et al. 2021

Cardiol J.

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“…The effectiveness of defibrillation is affected by many elements, including the quality of chest compression, electrical current flow through the chest, and exclusion of potentially reversible causes of sudden cardiac arres, [26][27][28][29] and the use of antiarrhythmic drugs including amiodarone and lidocaine in shockable rhythms. 30 However, the choice of the drug used for shockable rhythms in sudden cardiac arrest may affect the survival of patients, the duration of the resuscitation, and thus, the neurological prognosis and quality of life.…”

Section: Discussionmentioning

confidence: 99%

Effect of amiodarone and lidocaine on shock-refractory cardiac arrest: a systematic review and meta-analysis

Ludwin¹,

Smereka²,

Nadolny³

et al. 2020

Kardiol Pol

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an important document on the basis of which AHA modified the recommendations on the use of antiarrhythmic drugs during and immediately after shock -refractory VF or pVT cardiac arrest, enabling the use of either amiodarone or lidocaine in these cases. 3 Amiodarone prolongs phase 3 of the action potential of the cardiac conduction cells, reducing INTRODUCTION The European Resuscitation Council (ERC) and the American Heart Association (AHA) guidelines for resuscitation recommend amiodarone or lidocaine in patients with shock -resistant ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT). 1,2 The 2018 update of the International Liaison Committee on Resuscitation on lidocaine was

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“…Sudden cardiac arrest is a challenge for medical personnel, especially in the context of emergency medical teams, where there are a limited number of personnel in the resuscitation team [1,2]. Adrenaline has been a key component of advanced life support algorithms for many years.…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis appraising efficacy and safety of adrenaline for adult cardiopulmonary resuscitation

Ludwin¹,

Safiejko²,

Smereka

et al. 2021

Cardiol J.

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Background: There is a beneficial effect of adrenaline during adult cardiopulmonary resuscitation (CPR) from cardiac arrest but there is also uncertainty about its safety and effectiveness. The aim of this study was to evaluate the use of adrenaline versus nonadrenaline CPR. Methods: PubMed, ScienceDirect, Embase, CENTRAL (Cochrane Central Register of Controlled Trials) and Google Scholar databases were searched from their inception up to 1 st July 2020. Two reviewers independently assessed eligibility and risk of bias, with conflicts resolved by a third reviewer. Risk ratio (RR) or mean difference of groups were calculated using fixed or random-effect models. Results: Nineteen trials were identified. The use of adrenaline during CPR was associated with a significantly higher percentage of return of spontaneous circulation (ROSC) compared to non-adrenaline treatment (20.9% vs. 5.9%; RR = 1.87; 95% confidence interval [CI] 1.37-2.55; p < 0.001). The use of adrenaline in CPR was associated with ROSC at 19.4% and for non-adrenaline treatment-4.3% (RR = 3.23; 95% CI 1.89-5.53; p < 0.001). Survival to discharge (or 30-day survival) when using adrenaline was 6.8% compared to non-adrenaline treatment (5.5%; RR = 0.99; 95% CI 0.76-1.30; p = 0.97). However, the use of adrenaline was associated with a worse neurological outcome (1.6% vs. 2.2%; RR = 0.57; 95% CI 0.42-0.78; p < 0.001). Conclusions: This review suggests that resuscitation with adrenaline is associated with the return of spontaneous circulation and survival to hospital discharge, but no higher effectiveness was observed at discharge with favorable neurological outcome. The analysis showed higher effectiveness of ROSC and survival to hospital discharge in non-shockable rhythms. But more multicenter randomized controlled trials are needed in the future.

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Is low voltage ventricular fibrillation still a diagnostic problem?

Cited by 3 publications

References 7 publications

Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study

Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study

Effect of amiodarone and lidocaine on shock-refractory cardiac arrest: a systematic review and meta-analysis

Systematic review and meta-analysis appraising efficacy and safety of adrenaline for adult cardiopulmonary resuscitation

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