Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, South Korea.
Resuscitation. 2019 Oct;143:100-105. doi: 10.1016/j.resuscitation.2019.08.022. Epub 2019 Aug 20.
Current cardiopulmonary resuscitation guidelines recommend performing defibrillation every 2 min during resuscitation. This study aimed to compare the rate of successful defibrillation using 1- and 2-min defibrillation intervals.
Twenty-six pigs were randomly assigned to 1- or 2-min interval groups. After inducing ventricular fibrillation (VF), we observed pigs for 2 min. Thereafter, basic life support was initiated with a 30:2 compression-to-ventilation ratio for 8 min. Defibrillation was performed with an energy of 2 J/kg at 10 min after VF and was repeated every 1 or 2 min according to randomization. Advanced cardiac life support, including continuous chest compression with ventilation every 6 s and intravenous injection of 1 mg epinephrine every 3 min, was performed until the return of spontaneous circulation (ROSC) or until 20 min after VF induction. Haemodynamic parameters and baseline arterial blood gas profiles were compared between groups. ROSC, 24 -h survival, and the neurologic deficit score (NDS) were evaluated at 24 h.
Haemodynamic parameters during resuscitation and baseline arterial blood gas profiles did not differ between groups. ROSC was more frequently observed in the 1-min interval group (p = 0.047). Time to ROSC was not different between groups (p = 0.054). The 24 -h survival was higher (p = 0.047) and NDS at 24 h was lower (92 ± 175) in the 1-min interval group than in the 2-min interval group (272 ± 190) (p = 0.028).
Defibrillation success and resuscitation outcomes were superior when using a 1-min defibrillation interval in animal models of cardiac arrest.
目前的心肺复苏指南建议在复苏过程中每 2 分钟进行一次除颤。本研究旨在比较使用 1 分钟和 2 分钟除颤间隔的除颤成功率。
将 26 头猪随机分为 1 分钟或 2 分钟间隔组。在诱发心室颤动（VF）后，我们观察猪 2 分钟。此后，以 30:2 的按压通气比进行基础生命支持 8 分钟。VF 后 10 分钟给予 2J/kg 的能量进行除颤，根据随机分组每 1 或 2 分钟重复一次。高级心脏生命支持包括持续胸外按压，每 6 秒通气一次，每 3 分钟静脉注射 1mg 肾上腺素，持续至自主循环恢复（ROSC）或 VF 诱导后 20 分钟。比较两组之间的血流动力学参数和基线动脉血气谱。在 24 小时评估 ROSC、24 小时存活率和神经功能缺损评分（NDS）。
复苏期间的血流动力学参数和基线动脉血气谱在两组之间没有差异。1 分钟间隔组更频繁地观察到 ROSC（p=0.047）。两组之间 ROSC 时间无差异（p=0.054）。24 小时存活率更高（p=0.047），24 小时 NDS 较低（1 分钟间隔组 92±175，2 分钟间隔组 272±190）（p=0.028）。
在心脏骤停动物模型中，使用 1 分钟除颤间隔可提高除颤成功率和复苏效果。
