open access

https://hdl.handle.net/2115/38595

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

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

英語

2009-05

Elsevier Inc.

The American Journal of Emergency Medicine

27(4)

470-474

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.

学術雑誌論文

Accepted Manuscript

0735-6757