Kerber R E, Jensen S R, Gascho J A, Grayzel J, Hoyt R, Kennedy J
Am J Cardiol. 1983 Oct 1;52(7):739-45. doi: 10.1016/0002-9149(83)90408-3.
Previous studies have suggested that a number of factors may influence the ability to defibrillate: the transthoracic resistance and resultant current flow, the paddle electrode size, the duration of preshock ventricular fibrillation (VF) and cardiopulmonary resuscitation, metabolic abnormalities, body weight, the shock energy selected, and whether the patient is receiving lidocaine. To examine the effect of these variables, a prospective study was conducted of 183 patients who received direct-current shocks for VF. Overall defibrillation rates approached 90%, even in patients with secondary VF, but rates of successful resuscitation and survival were much lower. Patients who never defibrillated despite multiple shocks had a prolonged duration of cardiopulmonary resuscitation preceding the first shock (21 +/- 14 minutes) and systemic hypoxia and acidosis. These conditions tended to occur in patients who initially had cardiac arrest from causes other than VF: asystole, severe bradycardia and electromechanical dissociation. In such patients, VF developed only as a late event, which was then often unresponsive to attempted defibrillation. The other factors examined were not major determinants of defibrillation.
先前的研究表明，一些因素可能会影响除颤能力：胸壁电阻和由此产生的电流、电极板大小、电击前室颤（VF）持续时间和心肺复苏情况、代谢异常、体重、所选电击能量，以及患者是否正在接受利多卡因治疗。为了研究这些变量的影响，对183例接受直流电电击治疗VF的患者进行了一项前瞻性研究。总体除颤率接近90%，即使是继发性VF患者，但成功复苏和存活的比例要低得多。尽管多次电击仍未除颤的患者在首次电击前有较长的心肺复苏时间（21±14分钟），并伴有全身缺氧和酸中毒。这些情况往往发生在最初因VF以外的原因导致心脏骤停的患者中：心脏停搏、严重心动过缓和电机械分离。在这类患者中，VF仅在后期出现，然后往往对尝试除颤无反应。所研究的其他因素并非除颤的主要决定因素。
