(Circulation. 2000;102:1780.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Multicenter, Randomized, Controlled Trial of 150-J Biphasic Shocks Compared With 200- to 360-J Monophasic Shocks in the Resuscitation of Out-of-Hospital Cardiac Arrest Victims
From Johannes Gutenberg-Universitaet (T.S., B.W.), Mainz, Germany; St Jan Hospital (P.R.M.), Brugge, Belgium; Feuerwehr Hamburg (H.P.), Hamburg, Germany; Helsinki City EMS (M.K.), Helsinki, Finland; Agilent Technologies Heartstream Operation (B.E.G., J.K.R.), Seattle, Wash; Henry Ford Hospital (W.D.W.), Detroit, Mich; University Hospital (L.B.), Antwerp, Belgium; and University of Wales College of Medicine (D.C.), Cardiff, UK.
Correspondence to Benno Wolcke, MD, Clinic of Anaesthesiology, The Johannes Gutenberg-University Medical School, Langenbeckstr 1, D-55131 Mainz, Germany. E-mail wolcke{at}mail.Uni-Mainz.de
Background—In the present study, we compared an automatic external defibrillator (AED) that delivers 150-J biphasic shocks with traditional high-energy (200- to 360-J) monophasic AEDs.
Methods and Results—AEDs were prospectively randomized according to defibrillation waveform on a daily basis in 4 emergency medical services systems. Defibrillation efficacy, survival to hospital admission and discharge, return of spontaneous circulation, and neurological status at discharge (cerebral performance category) were compared. Of 338 patients with out-of-hospital cardiac arrest, 115 had a cardiac etiology, presented with ventricular fibrillation, and were shocked with an AED. The time from the emergency call to the first shock was 8.9±3.0 (mean±SD) minutes.
Conclusions—The 150-J biphasic waveform defibrillated at higher rates, resulting in more patients who achieved a return of spontaneous circulation. Although survival rates to hospital admission and discharge did not differ, discharged patients who had been resuscitated with biphasic shocks were more likely to have good cerebral performance.
Key Words: defibrillation • resuscitation • heart arrest • heart-arrest device
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