Abstract 233: What Is the Evidence for the Use of Automated External Defibrillators in Infants?
Background: Automated external defibrillators (AEDs) have been used successfully in many populations to improve survival for out-of-hospital cardiac arrest. While ventricular fibrillation and pulseless ventricular tachycardia are more prevalent in adults, these arrhythmias do occur in infants. Historically, there has been controversy about the safety and efficacy of AEDs in this population. Therefore, we conducted a systematic review on the use of AEDs in infants.
Methods: The Cochrane library and Pubmed were searched for relevant studies that included automated external defibrillators in infants, any external defibrillation in infants, and simulation studies of algorithms used by AEDs on pediatric arrhythmias.
Results: There were four studies on the accuracy of AEDs in recognizing pediatric arrhythmias. The algorithms used by AEDs had high sensitivity and specificity for pediatric arrhythmias and very rarely recommended a shock inappropriately. Case reports (n=2) demonstrated successful use of AED in infants and a retrospective review (n=1) of pediatric pads for AEDs included infants. Six studies addressed defibrillation dosages used. The energy doses delivered by AEDs were high, though in the range that have been used in out-of-hospital arrest. Additionally, there were data to suggest that 2-4 J/kg may not be effective defibrillation doses for many children.
Conclusions: There are limited data from clinical studies on AED use if infants and no randomized clinical trials. However, available evidence suggests that AEDs are safe and effective in this population. As survival is unlikely in the absence of prompt defibrillation for ventricular fibrillation or pulseless ventricular tachycardia, AEDs should be used in infants with suspected cardiac arrest.
Author Disclosures: J.W. Rossano: None. W. Jones: None. S. Lerakis: None. M. Millin: None. I. Nemeth: None. P. Cassan: None. J. Shook: None. S. Kennedy: None. D. Markenson: None. R.N. Bradley: None.
- © 2014 by American Heart Association, Inc.