Biphasic versus monophasic defibrillation in out-of-hospital cardiac arrest: a systematic review and meta-analysis.
Am J Emerg Med
; 31(10): 1472-8, 2013 Oct.
Article
em En
| MEDLINE
| ID: mdl-24035505
ABSTRACT
OBJECTIVE:
Biphasic defibrillation is more effective than monophasic one in controlled in-hospital conditions. The present review evaluated the performance of both waveforms in the defibrillation of patients of out-of-hospital cardiac arrest (OHCA) with initial ventricular fibrillation (Vf) rhythm under the context of current recommendations for cardiopulmonary resuscitation.METHODS:
From inception to June 2012, Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched systemically for randomized controlled trials (RCTs) and observational cohort studies that compared the effects of biphasic and monophasic shocks on Vf termination, return of spontaneous circulation (ROSC), and survival to hospital discharge in OHCA patients with initial Vf rhythm. No restrictions were applied regarding language, population, or publication year.RESULTS:
Four RCTs including 572 patients were identified from 131 potentially relevant references for meta-analysis. The synthesis of these RCTs yielded fixed-effect pooled risk ratios (RRs) for biphasic and monophasic waveforms on Vf termination survival to hospital discharge (RR, 1.14; 95% CI, [0.84-1.54]).CONCLUSION:
Biphasic waveforms did not seem superior to monophasic ones with respect to Vf termination, ROSC, or survival to hospital discharge in OHCA patients with initial Vf rhythm under the context of current guidelines. However, most trials were conducted in accordance with previous guidelines for cardiopulmonary resuscitation. Therefore, further trials are needed to clarify this issue.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cardioversão Elétrica
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Parada Cardíaca Extra-Hospitalar
Tipo de estudo:
Clinical_trials
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Observational_studies
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Risk_factors_studies
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Systematic_reviews
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Am J Emerg Med
Ano de publicação:
2013
Tipo de documento:
Article