Kroll Mark W, Fish Raymond M, Calkins Hugh, Halperin Henry, Lakkireddy Dhanunjaya, Panescu Dorin
Biomedical Engineering Dept. at the University of Minnesota, Minneapolis, MN, USA.
Annu Int Conf IEEE Eng Med Biol Soc. 2012;2012:689-93. doi: 10.1109/EMBC.2012.6346025.
Accidental electrocutions kill about 1000 individuals annually in the USA alone. There has not been a systematic review or modeling of elapsed time duration defibrillation success rates following electrically-induced VF. With such a model, there may be an opportunity to improve the outcomes for industrial electrocutions and further understand arrest-related-deaths where a TASER(®) electrical weapon was involved. We searched for MedLine indexed papers dealing with defibrillation success following electrically-induced VF with time durations of 1 minute or greater post VF induction. We found 10 studies covering a total of 191 experiments for defibrillation of electrically-induced VF for post-induction durations out to 16 minutes including 0-9 minutes of pre-shock chest compressions. The results were fitted to a logistic regression model. Total minutes of VF and use of pre-shock chest compressions were significant predictors of success (p < .00005 and p= .003 respectively). The number of minutes of chest compressions was not a predictor of success. With no compressions, the 90% confidence of successful defibrillation is reached at 6 minutes and the median time limit for success is 9.5 minutes. However, with pre-shock chest compressions, the modeled data suggest a 90% success rate at 10 minutes and a 50% rate at 14 minutes.1.
仅在美国,每年就有大约1000人因意外触电死亡。对于电诱导室颤后除颤成功率与时间持续关系,尚未有系统的综述或模型。有了这样一个模型,或许有机会改善工业触电事故的结果,并进一步了解涉及泰瑟枪(®)电击武器的心脏骤停相关死亡情况。我们检索了MedLine索引的论文,这些论文涉及电诱导室颤后1分钟或更长时间的除颤成功率。我们发现了10项研究,总共涵盖191次电诱导室颤除颤实验,室颤诱导后的持续时间长达16分钟,包括电击前0 - 9分钟的胸部按压。结果被拟合到一个逻辑回归模型中。室颤总时长和电击前胸部按压的使用是成功的显著预测因素(分别为p <.00005和p =.003)。胸部按压的分钟数不是成功的预测因素。在没有按压的情况下,6分钟时达到成功除颤的90%置信度,成功的中位时间限制是9.5分钟。然而,在电击前进行胸部按压时,模型数据显示10分钟时成功率为90%,14分钟时为50%。