scholarly journals ECG Spectrum Analysis Predicts Return of Spontaneous Circulation following Prolonged Ventricular Fibrillation

1993 ◽  
Vol 8 (S2) ◽  
pp. S61-S61 ◽  
Author(s):  
J.J Menegazzi ◽  
S Watanabe ◽  
M Klain ◽  
A Doctor
Keyword(s):  
Ventricular Fibrillation ◽  
Spectrum Analysis ◽  
Spontaneous Circulation ◽  
Return Of Spontaneous Circulation

scholarly journals Comparison of Resuscitation Outcomes Between 2‐ or 3‐Stacked Defibrillation Strategies With Minimally Interrupted Chest Compression and the Single Defibrillation Strategy: A Swine Cardiac Arrest Model

2021 ◽  
Vol 10 (18) ◽  
Author(s):  
Soyeong Kim ◽  
Woo Jin Jung ◽  
Young Il Roh ◽  
Tae Youn Kim ◽  
Sung Oh Hwang ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Chest Compression ◽  
Neurological Deficit ◽  
Life Support ◽  
Spontaneous Circulation ◽  
Shock Group ◽  
Return Of Spontaneous Circulation ◽  
Single Shock ◽  
Neurological Deficit Score

Background There is controversy over whether the number and mode of electrical shock are optimal for successful defibrillation. Methods and Results Fifty‐four pigs were randomly assigned to 3 groups. After inducing ventricular fibrillation and a 2‐minute downtime, basic life support was initiated with a 30:2 compression/ventilation ratio for 8 minutes. Subsequently, 20 minutes of advanced life support, including asynchronous ventilation, every 10 chest compressions with 15 L/min of oxygen, was delivered. Animals of the single shock group received a single shock, animals of the 2‐stacked shock group received 2 consecutive shocks, and animals of the 3‐stacked shock group received 3 consecutive shocks. Animals with the return of spontaneous circulation underwent post–cardiac arrest care for 12 hours. The rates of successful defibrillation, return of spontaneous circulation, 24‐hour survival, and 48‐hour survival and neurological deficit score were compared between the groups. Hemodynamic parameters, arterial blood gas profiles, troponin I, and cardiac output were not different between the groups. There was a significant difference in chest compression fraction between the single and 3‐stacked shock groups ( P <0.001), although there was no difference between the single and 2‐stacked shock groups ( P =0.022) or the 2‐stacked and 3‐stacked shock groups ( P =0.040). The rates of successful defibrillation, return of spontaneous circulation, 24‐hour survival, and 48‐hour survival were higher in the 2‐ and 3‐stacked shock groups than in the single shock group ( P =0.021, P =0.015, and P =0.021, respectively). Neurological deficit score at 48 hours was not different between the groups. Conclusions A stacked shock strategy was superior to a single shock strategy for successful defibrillation and better resuscitation outcomes in treating ventricular fibrillation.

Abstract 332: Controlling the Heart Rate After Resuscitation Decreases Duration of Survival in a Rat Model of Cardiac Arrest

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Zhangle Hu ◽  
Jin Yang ◽  
Qinyue Guo ◽  
Xiaobo Wu ◽  
Jennifer Bradley ◽  
...  
Keyword(s):  
Heart Rate ◽  
Ventricular Fibrillation ◽  
Femoral Artery ◽  
Myocardial Function ◽  
Myocardial Dysfunction ◽  
Spontaneous Circulation ◽  
Myocardial Oxygen Demand ◽  
High Heart Rate ◽  
Successful Resuscitation ◽  
Return Of Spontaneous Circulation

Introduction: A high heart rate (HR) after return of spontaneous circulation (ROSC) due to increased sympathetic drive is a compensatory mechanism of postresuscitation myocardial dysfunction. However, it increases myocardial oxygen demand and impairs oxygen supply, and may increase the severity of myocardial ischemia. Hypothesis: Reduction of HR would improve postresuscitation myocardial dysfunction. Methods: Thirty-two male Sprague-Dawley rats weighing 450-550g were randomized into 2 groups: 1) Saline group: Ventricular fibrillation was induced and untreated for 6 min followed by 8 min of CPR. Rats received 0.9% NaCl solution administered from the femoral artery at 1h after return of spontaneous circulation (ROSC). 2) Drug group: Ventricular fibrillation was induced and untreated for 6 min followed by 8 min of CPR. Rats received Ivabradine (0.5ml/kg) solution administered from the femoral artery at 1h after ROSC. All catheters including the endotracheal tube were removed at PR 5h and animals were returned to their cages and closely monitored for the duration of survival. Results: For both groups, postresuscitation myocardial function as expressed by CO, EF, MPI was impaired compared to baseline values. However, the IVA group was significantly inferior to the SAL group with myocardial function index from PR 120’ to PR 300 (*p<0.01) (Figure 1).A significantly shortened duration of survival was observed in the IVA group compared to the SAL group (p<0.01) (Figure 2). Conclusions: Lowering HR significantly reduces myocardial function the duration of survival following successful resuscitation.

Adverse postresuscitation myocardial effects elicited by buffer-induced alkalemia ameliorated by NHE-1 inhibition in a rat model of ventricular fibrillation

2016 ◽  
Vol 121 (5) ◽  
pp. 1160-1168 ◽  
Author(s):  
Lorissa Lamoureux ◽  
Jeejabai Radhakrishnan ◽  
Thomas G. Mason ◽  
Jeffrey A. Kraut ◽  
Raúl J. Gazmuri
Keyword(s):  
Ventricular Fibrillation ◽  
Myocardial Function ◽  
Myocardial Dysfunction ◽  
Spontaneous Circulation ◽  
Male Rats ◽  
Intracellular Acidosis ◽  
Acid Base ◽  
Bicarbonate Buffer ◽  
Return Of Spontaneous Circulation ◽  
Blood Ph

Major myocardial abnormalities occur during cardiac arrest and resuscitation including intracellular acidosis—partly caused by CO2 accumulation—and activation of the Na+-H+ exchanger isoform-1 (NHE-1). We hypothesized that a favorable interaction may result from NHE-1 inhibition during cardiac resuscitation followed by administration of a CO2-consuming buffer upon return of spontaneous circulation (ROSC). Ventricular fibrillation was electrically induced in 24 male rats and left untreated for 8 min followed by defibrillation after 8 min of cardiopulmonary resuscitation (CPR). Rats were randomized 1:1:1 to the NHE-1 inhibitor zoniporide or vehicle during CPR and disodium carbonate/sodium bicarbonate buffer or normal saline (30 ml/kg) after ROSC. Survival at 240 min declined from 100% with Zoniporide/Saline to 50% with Zoniporide/Buffer and 25% with Vehicle/Buffer ( P = 0.004), explained by worsening postresuscitation myocardial dysfunction. Marked alkalemia occurred after buffer administration along with lactatemia that was maximal after Vehicle/Buffer, attenuated by Zoniporide/Buffer, and minimal with Zoniporide/Saline [13.3 ± 4.8 (SD), 9.2 ± 4.6, and 2.7 ± 1.0 mmol/l; P ≤ 0.001]. We attributed the intense postresuscitation lactatemia to enhanced glycolysis consequent to severe buffer-induced alkalemia transmitted intracellularly by an active NHE-1. We attributed the worsened postresuscitation myocardial dysfunction also to severe alkalemia intensifying Na+ entry via NHE-1 with consequent Ca2+ overload injuring mitochondria, evidenced by increased plasma cytochrome c. Both buffer-induced effects were ameliorated by zoniporide. Accordingly, buffer-induced alkalemia after ROSC worsened myocardial function and survival, likely through enhancing NHE-1 activity. Zoniporide attenuated these effects and uncovered a complex postresuscitation acid-base physiology whereby blood pH drives NHE-1 activity and compromises mitochondrial function and integrity along with myocardial function and survival.

Clinical case review: out-of-hospital cardiac arrest following thyroid storm

2021 ◽  
Vol 13 (4) ◽  
pp. 144-150
Author(s):  
Matthew Hale ◽  
Jo Mildenhall ◽  
Christopher Hook ◽  
James Burt
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hospital Discharge ◽  
Clinical Case ◽  
Spontaneous Circulation ◽  
Thyroid Storm ◽  
Case Review ◽  
Return Of Spontaneous Circulation ◽  
Good Outcome ◽  
Hospital Cardiac Arrest

Acute thyrotoxicosis (thyroid storm) caused by hyperthyroidism is a rare but severe endocrine imbalance which, in extreme cases, may lead to ventricular fibrillation and ultimately, without intervention, death. The authors attended such an incident and, following clinical interventions, achieved return of spontaneous circulation with a good outcome for the patient and subsequent hospital discharge.

Defibrillation and pacing during cardiac arrest

2016 ◽  
Author(s):  
Charles D. Deakin
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Electrical Current ◽  
Spontaneous Circulation ◽  
Energy Strategy ◽  
Chest Compressions ◽  
Return Of Spontaneous Circulation ◽  
Fixed Energy ◽  
Life Saving ◽  
Initial Shock

Defibrillation is the passage of electrical current across the myocardium to allow synchronized repolarisation and return of a perfusing rhythm. It is now an established intervention for patients in shockable rhythms during cardiac arrest and is administered every 2 minutes during resuscitation until return of spontaneous circulation. Modern biphasic waveforms are more effective than older monophasic waveforms, achieving first shock success rate of approximately 90%. For ventricular fibrillation in adults, the initial shock should be delivered at 150 J, and if further shocks are required, escalating energy is probably more effective than a fixed energy strategy. All paediatric shocks should be delivered at 4 J/kg. Although it is important to stand clear of the patient when the shock is delivered, defibrillation should be administered with minimal interruption to resuscitation, ideally resulting in a pause to chest compressions of no more than 5 seconds. External pacing may be life-saving in patients refractory to pharmacological support of bradyarrhythmias, but is ineffective for asystole.

Novel CPR system that predicts return of spontaneous circulation from amplitude spectral area before electric shock in ventricular fibrillation

Resuscitation ◽  
2017 ◽  
Vol 113 ◽  
pp. 8-12 ◽  
Author(s):  
Yoshihide Nakagawa ◽  
Mari Amino ◽  
Sadaki Inokuchi ◽  
Satoshi Hayashi ◽  
Tsutomu Wakabayashi ◽  
...  
Keyword(s):  
Ventricular Fibrillation ◽  
Electric Shock ◽  
Spontaneous Circulation ◽  
Return Of Spontaneous Circulation ◽  
Spectral Area
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