BACKGROUND: Cardiopulmonary resuscitation (CPR) creates artifacts on the ECG and, with automated defibrillators, a pause in CPR is mandatory during rhythm analysis. The rate of return of spontaneous circulation (ROSC) is reduced with increased duration of this hands-off interval in rats. We analyzed whether similar hands-off intervals in humans with ventricular fibrillation causes changes in the ECG predicting a lower probability of ROSC. METHODS AND RESULTS: The probability of ROSC after a shock was continually determined from ECG signal characteristics for up to 20 seconds of 634 such hands-off intervals in patients with ventricular fibrillation. In hands-off intervals with an initially high (40% to 100%) or median (25% to 40%) probability for ROSC, the probability was gradually reduced with time to a median of 8% to 11% after 20 seconds (P<0.001). In episodes with a low initial probability (0% to 25%; median, 5%), there was no further reduction with time. CONCLUSIONS: The interval between discontinuation of chest compressions and delivery of a shock should be kept as short as possible.
BACKGROUND: Cardiopulmonary resuscitation (CPR) creates artifacts on the ECG and, with automated defibrillators, a pause in CPR is mandatory during rhythm analysis. The rate of return of spontaneous circulation (ROSC) is reduced with increased duration of this hands-off interval in rats. We analyzed whether similar hands-off intervals in humans with ventricular fibrillation causes changes in the ECG predicting a lower probability of ROSC. METHODS AND RESULTS: The probability of ROSC after a shock was continually determined from ECG signal characteristics for up to 20 seconds of 634 such hands-off intervals in patients with ventricular fibrillation. In hands-off intervals with an initially high (40% to 100%) or median (25% to 40%) probability for ROSC, the probability was gradually reduced with time to a median of 8% to 11% after 20 seconds (P<0.001). In episodes with a low initial probability (0% to 25%; median, 5%), there was no further reduction with time. CONCLUSIONS: The interval between discontinuation of chest compressions and delivery of a shock should be kept as short as possible.
Authors: Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman Journal: Circulation Date: 2010-10-19 Impact factor: 29.690
Authors: Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman Journal: Pediatrics Date: 2010-10-18 Impact factor: 7.124
Authors: Christoph H R Wiese; Utz Bartels; Anna Bergmann; Ingo Bergmann; Jan Bahr; Bernhard M Graf Journal: Wien Klin Wochenschr Date: 2008 Impact factor: 1.704
Authors: Ian G Stiell; Clif Callaway; Dan Davis; Tom Terndrup; Judy Powell; Andrea Cook; Peter J Kudenchuk; Mohamud Daya; Richard Kerber; Ahamed Idris; Laurie J Morrison; Tom Aufderheide Journal: Resuscitation Date: 2008-05-19 Impact factor: 5.262
Authors: J P Nolan; C D Deakin; J Soar; B W Böttiger; G Smith; M Baubin; B Dirks; V Wenzel Journal: Notf Rett Med Date: 2006-02-01 Impact factor: 0.826