Young Hwan Lee1, Kui Ja Lee2, Yong Hun Min3, Hee Cheol Ahn4, You Dong Sohn5, Won Woong Lee6, Young Taeck Oh7, Gyu Chong Cho8, Jeong Yeol Seo9, Dong Hyuk Shin10, Sang O Park11, Seung Min Park12. 1. Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea; Department of emergency medicine, College of Medicine, Kangwon National University, Chuncheon, Gangwon 200-701, Republic of Korea. Electronic address: hwaniyo@naver.com. 2. Department of Emergency Medical Technology, Seojeong College, Yangju, Republic of Korea. Electronic address: dlrnlwk@hanmail.net. 3. Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea. Electronic address: xgaryx@naver.com. 4. Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea. Electronic address: gsemdr68@hallym.or.kr. 5. Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea. Electronic address: medysohn@hallym.or.kr. 6. Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea. Electronic address: woong421@naver.com. 7. Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea; Department of emergency medicine, College of Medicine, Kangwon National University, Chuncheon, Gangwon 200-701, Republic of Korea. Electronic address: powerfreeze@hanmail.net. 8. Department of Emergency Medicine, School of Medicine, Hallym University, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea. Electronic address: emdrcho@empal.com. 9. Department of Emergency Medicine, School of Medicine, Hallym University, Chuncheon, Republic of Korea. Electronic address: siris94@hallym.or.kr. 10. Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School Medicine, Seoul, Republic of Korea. Electronic address: sinndhk@medimail.co.kr. 11. Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea. Electronic address: 20080563@kuh.ac.kr. 12. Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea. Electronic address: aukawa1@naver.com.
Abstract
AIMS: This study aimed to evaluate the effects of esmolol treatment for patients with refractory ventricular fibrillation (RVF) in out-of-hospital cardiac arrest (OHCA). METHODS: This single-centre retrospective pre-post study evaluated patients who were treated between January 2012 and December 2015. Some patients had received esmolol (loading dose: 500μg/kg, infusion: 0-100μg/kg/min) for RVF (≥3 defibrillation attempts), after obtaining consent from the patient's guardian. RESULTS: Twenty-five patients did not receive esmolol (the control group), and 16 patients received esmolol. Sustained return of spontaneous circulation (ROSC) was significantly more common in the esmolol group, compared to the control group (56% vs. 16%, p=0.007). Survival and good neurological outcomes at 30 days, 3 months and at 6 months were >2-fold better in the esmolol group, compared to the control group, although these increases were not statistically significant. CONCLUSIONS: The findings of our study suggest that administration of esmolol may increase the rate of sustained ROSC and ICU survival among patients with RVF in OHCA. Further larger-scale, prospective studies are necessary to determine the effect of esmolol for RVF in OHCA.
AIMS: This study aimed to evaluate the effects of esmolol treatment for patients with refractory ventricular fibrillation (RVF) in out-of-hospital cardiac arrest (OHCA). METHODS: This single-centre retrospective pre-post study evaluated patients who were treated between January 2012 and December 2015. Some patients had received esmolol (loading dose: 500μg/kg, infusion: 0-100μg/kg/min) for RVF (≥3 defibrillation attempts), after obtaining consent from the patient's guardian. RESULTS: Twenty-five patients did not receive esmolol (the control group), and 16 patients received esmolol. Sustained return of spontaneous circulation (ROSC) was significantly more common in the esmolol group, compared to the control group (56% vs. 16%, p=0.007). Survival and good neurological outcomes at 30 days, 3 months and at 6 months were >2-fold better in the esmolol group, compared to the control group, although these increases were not statistically significant. CONCLUSIONS: The findings of our study suggest that administration of esmolol may increase the rate of sustained ROSC and ICU survival among patients with RVF in OHCA. Further larger-scale, prospective studies are necessary to determine the effect of esmolol for RVF in OHCA.
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