![]() ![]() No defined optimal pulse interval in any of the published papers or cases.Simultaneous vs Sequential = This could have been the stepping stone to a study that helped identify which was more effective.Did not come to a consensus in the literature on the definition of refractory VF.Selection bias with case reports limits us in knowing how many times DSD was performed without any success in the clinical setting.Performing a RCT would be difficult as RVF is a rare phenomenon Studies are not prospective or randomized.Commented on the findings of other published papers that did not meet their inclusion criteria.Further inclusion required unprovoked cardiac arrest or occurrence of V-Fib and reports on patients rather than summary statistics.Inclusion and exclusion criteria as described above.Used a wide variety of databases: Google Scholar, Cochrane Library, Medline, PubMed.Very inclusive literature review of all published cases between 19.On average DSD was performed a total of 2 times. ![]() Mean time to DSD was 31.4 minutes +/- 12.1% of the patients died within 24 hours of arresting.28% had a CPC 77% of the 39 had their VF successfully terminated with DSD.One paper had 10 cases, another had 12, another had 7.12 published papers describing a total of 38 cases.Lack of refractory ventricular fibrillation.Published papers found using the following search terms:.They present a case of RVF in a patient with cardiac arrest, on whom DSD was successful in reversion to sinus rhythm and provide a thorough review of similar cases in the literature.Ĭlinical Question: Does dual sequential defibrillation(DSD) lead to more successful conversion of refractory ventricular fibrillation, return of spontaneous circulation (ROSC) or improved Cerebral Performance Category (CPC) Scores? Inclusion Criteria: The authors of this review utilize the term dual sequential defibrillation (DSD). ![]() 9-13 The terms “sequential” and “simultaneous” are often used interchangably due to the lack of accurately measuring pulse intervals when performing dual defibrillation in the actual clinical environment. 8-12 It is important to note and distinguish that dual defibrillation can either be simultaneous or sequential depending on the duration of the defibrillation potential as well as the intershock interval between the two defibrillator shocks. 6,7 Several case reports have shown success with excellent neurologic outcomes in terminating RVF using dual defibrillation after failure of traditional Advance Cardiac Life Support (ACLS) measures. 3-5 Patients who experience RVF during their cardiac arrest have a mortality of up to 97%. 2,3Although the estimated incidence of refractory ventricular fibrillation is 0.5-0.6 per 100,000 of the population, some authors report that 10-25% of cardiac arrest cases could develop RVF or recurrent VF. 1 Refractory Ventricular Fibrillation (RVF) is a complication of cardiac arrest and has varying definitions in the literature but is commonly defined as ventricular fibrillation that does not respond to, or resists, three or more defibrillation attempts. Background: In the United States 424,000 out of hospital cardiac arrests occur per year with a 10.4% overall survival rate. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |