scholarly journals Correction to: Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation: retrospective analysis of prospectively collected prehospital data

Author(s):  
Dong Keon Lee ◽  
Yu Jin Kim ◽  
Giwoon Kim ◽  
Choung Ah. Lee ◽  
Hyung Jun Moon ◽  
...  
Author(s):  
Dong Keon Lee ◽  
Yu Jin Kim ◽  
Giwoon Kim ◽  
Choung Ah. Lee ◽  
Hyung Jun Moon ◽  
...  

Abstract Background The 2015 AHA guidelines recommend that amiodarone should be used for patients with refractory ventricular fibrillation (RVF). However, the optimal time interval between the incoming call and amiodarone administration (call-to-amiodarone administration interval) in RVF patients has not been investigated. We hypothesized that the time elapsed until amiodarone administration could affect the neurological outcome at hospital discharge in patients with RVF. Methods and results This study is a retrospective analysis of prospectively collected data. One hundred thirty-four patients were enrolled. In univariate logistic regression, the probability of a good neurological outcome at hospital discharge decreased as the time elapsed until amiodarone administration increased (OR 0.89 [95% CI = 0.80–0.99]). In multivariate logistic regression, the patients who were administered amiodarone in less than 20 min showed higher rates of prehospital ROSC, survival at hospital arrival, any ROSC, survival at admission, survival to discharge, and good CPC at hospital discharge. The call-to-amiodarone administration interval of ≤20 min (OR 6.92, 95% CI 1.72–27.80) was the independent factor affecting the neurological outcome at hospital discharge. Conclusion Early amiodarone administration (≤ 20 min) showed better neurological outcome at hospital discharge for OHCA patients who showed initial ventricular fibrillation and subsequent RVF.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Luca Marengo ◽  
Wolfgang Ummenhofer ◽  
Gerster Pascal ◽  
Falko Harm ◽  
Marc Lüthy ◽  
...  

Introduction: Agonal respiration has been shown to be commonly associated with witnessed events, ventricular fibrillation, and increased survival during out-of-hospital cardiac arrest. There is little information on incidence of gasping for in-hospital cardiac arrest (IHCA). Our “Rapid Response Team” (RRT) missions were monitored between December 2010 and March 2015, and the prevalence of gasping and survival data for IHCA were investigated. Methods: A standardized extended in-hospital Utstein data set of all RRT-interventions occurring at the University Hospital Basel, Switzerland, from December 13, 2010 until March 31, 2015 was consecutively collected and recorded in Microsoft Excel (Microsoft Corp., USA). Data were analyzed using IBM SPSS Statistics 22.0 (IBM Corp., USA), and are presented as descriptive statistics. Results: The RRT was activated for 636 patients, with 459 having a life-threatening status (72%; 33 missing). 270 patients (59%) suffered IHCA. Ventricular fibrillation or pulseless ventricular tachycardia occurred in 42 patients (16% of CA) and were associated with improved return of spontaneous circulation (ROSC) (36 (97%) vs. 143 (67%; p<0.001)), hospital discharge (25 (68%) vs. 48 (23%; p<0.001)), and discharge with good neurological outcome (Cerebral Performance Categories of 1 or 2 (CPC) (21 (55%) vs. 41 (19%; p<0.001)). Gasping was seen in 128 patients (57% of CA; 46 missing) and was associated with an overall improved ROSC (99 (78%) vs. 55 (59%; p=0.003)). In CAs occurring on the ward (154, 57% of all CAs), gasping was associated with a higher proportion of shockable rhythms (11 (16%) vs. 2 (3%; p=0.019)), improved ROSC (62 (90%) vs. 34 (55%; p<0.001)), and hospital discharge (21 (32%) vs. 7 (11%; p=0.006)). Gasping was not associated with neurological outcome. Conclusions: Gasping was frequently observed accompanying IHCA. The faster in-hospital patient access is probably the reason for the higher prevalence compared to the prehospital setting. For CA on the ward without continuous monitoring, gasping correlates with increased shockable rhythms, ROSC, and hospital discharge.


Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Katsutaka Hashiba ◽  
Yoshio Tahara ◽  
Kazuo Kimura ◽  
Tsutomu Endo ◽  
Kouichi Tamura ◽  
...  

Background: Effective advanced life support is one of the important link in the chain of survival. In Japan, the emergency medical service (EMS) personnel can perform defibrillation, advanced airway management, intravenous access and administration of epinephrine as an advanced life support intervention for the treatment of out-of-hospital cardiac arrest (OHCA). However, whether these interventions performed by EMS improves neurological outcomes remains unclear. Objective: To evaluate predictors of favorable neurological outcome in patients suffering OHCA with ventricular fibrillation (VF) witnessed by an EMS personnel. Methods: The Fire and Disaster Management Agency (FDMA) of Japan developed a nationwide database of a prospective population-based cohort using an Utstein-style template for OHCA patients since January 2005. To evaluate data after the publication of Guideline2010, data from January 2011 to December 2015 of this database was used for the current analysis. A multivariate logistic-regression analysis was performed to assess factors associated with favorable neurological outcome (defined as Cerebral Performance Category 1 or 2) 1 month after cardiac arrest. Results: Of the 629,471 patients documented for the study period, 2,301 adult patients with an OHCA of cardiac origin and VF for the initial rhythm witnessed by an EMS personnel were included in the present analysis. The overall mortality was 49.6%. Rate of return of spontaneous circulation and favorable neurological outcome were 53.4% and 44.8%, respectively. High age (OR0.387, 95%CI0.316-0.472, p<0.001), delayed defibrillation (OR0.598, 95%CI0.493-0.723, p<0.001), advanced airway management (OR0.305, 95%CI0.223-0.413, p<0.001), administration of epinephrine (OR0.356, 95%CI0.213-0.585, p<0.001) and multiple attempts of defibrillation (OR0.484, 95%CI0.402-0.582, p<0.001) were negatively associated with favorable neurological outcome. Conclusion: In patients with VF witnessed by EMS personnel, resuscitation efforts should simply focus on early defibrillation and CPR without advanced interventions.


2002 ◽  
Vol 15 (4) ◽  
pp. 334-343
Author(s):  
Cynthia A. Sanoski

Despite the use of conventional treatment modalities, the probability of survival for patients experiencing cardiac arrest due to ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) remains quite poor. Therefore, the management of cardiac arrest remains a challenge. The most recent Advanced Cardiovascular Life Support (ACLS) guidelines have adopted an evidence-based approach toward the treatment of pulseless VT/VF. A number of evidence-based changes have been made in the treatment algorithms for these life-threatening arrhythmias, including the new recommendations for using vasopressin and intravenous amiodarone. This article will provide an overview of the evidence-based approach that was used in the development of the 2000 ACLS guidelines and will summarize the key trials that were used to support the inclusion of vasopressin and intravenous amiodarone in the pulseless VT/VF treatment algorithm. Additionally, dosing and administration issues for these agents will be discussed.


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