OBJECTIVE: Current resuscitation guidelines recommend that defibrillation be undertaken as soon as possible in patients suffering a cardiac arrest where the cardiac rhythm is either ventricular fibrillation (VF) or ventricular tachycardia (VT). Evidence from animal and clinical studies suggests that outcomes may be improved if a period of cardiopulmonary resuscitation (CPR) is given prior to defibrillation. The objective of this study was to determine if 90 seconds of CPR before defibrillation improved survival. METHODS:Patients suffering non-paramedic witnessedVF/VT cardiac arrest were randomized to receive either 90 seconds of CPR before defibrillation (treatment) or immediate defibrillation (control). The study was carried out in Perth, Western Australia between June 2000 and June 2002. The primary endpoint was survival to hospital discharge with secondary endpoints of return of spontaneous circulation (ROSC) and survival at 1 year. RESULTS: A total of 256 patients underwent randomization. Baseline characteristics including response intervals were similar in both groups. Survival to hospital discharge in the CPR first group was 4.2% (5/119) compared with 5.1% (7/137) for the immediate defibrillation group (OR 0.81; 95%CI. 0.25-2.64). No difference in those achieving ROSC was observed between the groups (OR 1.16; 95% CI 0.49-2.80). CONCLUSION: Ninety seconds of CPR before defibrillation does not improve overall survival in patients suffering VF/VT cardiac arrests. Further studies to evaluate various aspects of this treatment strategy are required as published outcomes to date are inconclusive.
RCT Entities:
OBJECTIVE: Current resuscitation guidelines recommend that defibrillation be undertaken as soon as possible in patients suffering a cardiac arrest where the cardiac rhythm is either ventricular fibrillation (VF) or ventricular tachycardia (VT). Evidence from animal and clinical studies suggests that outcomes may be improved if a period of cardiopulmonary resuscitation (CPR) is given prior to defibrillation. The objective of this study was to determine if 90 seconds of CPR before defibrillation improved survival. METHODS:Patients suffering non-paramedic witnessed VF/VT cardiac arrest were randomized to receive either 90 seconds of CPR before defibrillation (treatment) or immediate defibrillation (control). The study was carried out in Perth, Western Australia between June 2000 and June 2002. The primary endpoint was survival to hospital discharge with secondary endpoints of return of spontaneous circulation (ROSC) and survival at 1 year. RESULTS: A total of 256 patients underwent randomization. Baseline characteristics including response intervals were similar in both groups. Survival to hospital discharge in the CPR first group was 4.2% (5/119) compared with 5.1% (7/137) for the immediate defibrillation group (OR 0.81; 95%CI. 0.25-2.64). No difference in those achieving ROSC was observed between the groups (OR 1.16; 95% CI 0.49-2.80). CONCLUSION: Ninety seconds of CPR before defibrillation does not improve overall survival in patients suffering VF/VT cardiac arrests. Further studies to evaluate various aspects of this treatment strategy are required as published outcomes to date are inconclusive.
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: Tom P Aufderheide; Carly Alexander; Charles Lick; Brent Myers; Laurie Romig; Levon Vartanian; Joseph Stothert; Scott McKnite; Tim Matsuura; Demetris Yannopoulos; Keith Lurie Journal: Crit Care Med Date: 2008-11 Impact factor: 7.598
Authors: Ian G Stiell; Graham Nichol; Brian G Leroux; Thomas D Rea; Joseph P Ornato; Judy Powell; James Christenson; Clifton W Callaway; Peter J Kudenchuk; Tom P Aufderheide; Ahamed H Idris; Mohamud R Daya; Henry E Wang; Laurie J Morrison; Daniel Davis; Douglas Andrusiek; Shannon Stephens; Sheldon Cheskes; Robert H Schmicker; Ray Fowler; Christian Vaillancourt; David Hostler; Dana Zive; Ronald G Pirrallo; Gary M Vilke; George Sopko; Myron Weisfeldt Journal: N Engl J Med Date: 2011-09-01 Impact factor: 91.245
Authors: Conor Deasy; Stephen Bernard; Peter Cameron; Ian Jacobs; Karen Smith; Cindy Hein; Hugh Grantham; Judith Finn Journal: BMC Emerg Med Date: 2011-10-13
Authors: Steven M Bradley; Erin E Gabriel; Tom P Aufderheide; Roxy Barnes; Jim Christenson; Daniel P Davis; Ian G Stiell; Graham Nichol Journal: Resuscitation Date: 2009-12-06 Impact factor: 5.262
Authors: Julia H Indik; Ronald W Hilwig; Mathias Zuercher; Karl B Kern; Marc D Berg; Robert A Berg Journal: Circ Arrhythm Electrophysiol Date: 2009-02-18
Authors: Julia H Indik; Madhan Shanmugasundaram; Daniel Allen; Amanda Valles; Karl B Kern; Ronald W Hilwig; Mathias Zuercher; Robert A Berg Journal: Resuscitation Date: 2009-10-04 Impact factor: 5.262