Defibrillation strategies for refractory ventricular fibrillation out-of-hospital cardiac arrest: A systematic review and network meta-analysis.
Ann Noninvasive Electrocardiol
; 28(5): e13075, 2023 09.
Article
en En
| MEDLINE
| ID: mdl-37482919
ABSTRACT
BACKGROUND AND OBJECTIVE:
Double sequential external defibrillation (DSED) and vector-change defibrillation (VCD) have been suggested to enhance clinical outcomes for patients with ventricular fibrillation (VF) refractory of standard defibrillation (SD). Therefore, this network meta-analysis aims to evaluate the comparative efficacy of DSED, VCD, and SD for refractory VF.METHODS:
A systematic review and network meta-analysis synthesizing randomized controlled trials (RCTs) and comparative observational studies retrieved from PubMed, EMBASE, WOS, SCOPUS, and Cochrane through November 15th, 2022. R software netmeta and netrank package (R version 4.2.0) and meta-insight software were used to pool dichotomous outcomes using odds ratio (OR) presented with the corresponding confidence interval (CI). Our protocol was prospectively published in PROSPERO with ID CRD42022378533.RESULTS:
We included seven studies with a total of 1632 participants. DSED was similar to SD in survival to hospital discharge (OR 1.14 with 95% CI [0.55, 2.83]), favorable neurological outcome (modified Rankin scale ≤2 or cerebral performance category ≤2) (OR 1.35 with 95% CI [0.46, 3.99]), and return of spontaneous circulation (ROSC) (OR 0.81 with 95% CI [0.43; 1.5]). In addition, VCD was similar to SD in survival to hospital discharge (OR 1.12 with 95% CI [0.27, 4.57]), favorable neurological outcome (OR 1.01 with 95% CI [0.18, 5.75]), and ROSC (OR 0.88 with 95% CI [0.24; 3.15]).CONCLUSION:
Double sequential external defibrillation and VCD were not associated with enhanced outcomes in patients with refractory VF out-of-hospital cardiac arrest, compared to SD. However, the current evidence is still inconclusive, warranting further large-scale RCTs.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Reanimación Cardiopulmonar
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Paro Cardíaco Extrahospitalario
Tipo de estudio:
Clinical_trials
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Guideline
/
Observational_studies
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Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Ann Noninvasive Electrocardiol
Asunto de la revista:
CARDIOLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Egipto