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Shortening of cardiopulmonary resuscitation time before the defibrillation worsens the outcome in out-of-hospital VF patients

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Title: Shortening of cardiopulmonary resuscitation time before the defibrillation worsens the outcome in out-of-hospital VF patients
Other Titles: Shortening of CPR time before the defibrillation worsens the outcome in out-of-hospital VF patients
Authors: Hayakawa, Mineji Browse this author →KAKEN DB
Gando, Satoshi Browse this author
Okamoto, Hiroyuki Browse this author
Asai, Yasufumi Browse this author
Uegaki, Shinji Browse this author
Makise, Hiroshi Browse this author
Issue Date: May-2009
Publisher: Elsevier Inc.
Journal Title: The American Journal of Emergency Medicine
Volume: 27
Issue: 4
Start Page: 470
End Page: 474
Publisher DOI: 10.1016/j.ajem.2008.03.043
PMID: 19555620
Abstract: Objective: To investigate the influence of cardiopulmonary resuscitation (CPR) time before the first defibrillation. Methods: The present study retrospectively analyzed the Utstein template records from April 1, 2002 to June 30, 2005. Patients who had out-of-hospital witnessed cardiac arrest caused by cardiac disease and who presented with ventricular fibrillation (VF) as the initial cardiac rhythm were included in the study. Before April 1, 2003, the emergency medical technician (EMT) needed to obtain telephone permission before attempting defibrillation, and CPR was continued until permission was received (CPR first). On and after April 1, 2003, the EMT was immediately able to attempt a defibrillation without obtaining permission (Shock first). Results: In 143 patients who had out-of-hospital witnessed VF, 43 patients and 100 patients were treated with the CPR first strategy and the Shock first strategy, respectively. The duration of CPR before the first defibrillation was longer in the CPR first group than that in the Shock first group. The CPR first group showed a higher rate of favorable neurological outcome 30 days after (28% vs. 14%, P = .048) and 1 year after cardiac arrest (26% vs. 11%, P = .033) than those of the Shock first group. In the patients with witnessed VF, a stepwise multiple logistic-regression analysis showed the CPR first strategy to improve the neurological outcome. Conclusions: In patients with out-of-hospital witnessed VF, sufficient CPR before the first defibrillation is considered to improve the neurological outcome in comparison to the performance of immediate defibrillation.
Type: article (author version)
URI: http://hdl.handle.net/2115/38595
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 早川 峰司

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