Multicenter, Randomized, Controlled Trial of 150-J Biphasic Shocks Compared With 200- to 360-J Monophasic Shocks in the Resuscitation of Out-of-Hospital Cardiac Arrest Victims

• Main Authors: Thomas Schneider, Leo Bossaert
• Other Authors: The Pennsylvania State University CiteSeerX Archives
• Format: Text
• Language: English
• Subjects: Orca
• Online Access: http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.462.148; http://210.38.57.228/151/re2/CPCR/asp/Resource/pdf/150J DF And 200-360J DF.pdf

for the Optimized Response to Cardiac Arrest (ORCA) Investigators Background—In the present study, we compared an automatic external defibrillator (AED) that delivers 150-J biphasic shocks with traditional high-energy (200- to 360-J) monophasic AEDs. Methods and Results—AEDs were prospectively randomized according to defibrillation waveform on a daily basis in 4 emergency medical services systems. Defibrillation efficacy, survival to hospital admission and discharge, return of spontaneous circulation, and neurological status at discharge (cerebral performance category) were compared. Of 338 patients with out-of-hospital cardiac arrest, 115 had a cardiac etiology, presented with ventricular fibrillation, and were shocked with an AED. The time from the emergency call to the first shock was 8.963.0 (mean6SD) minutes. Conclusions—The 150-J biphasic waveform defibrillated at higher rates, resulting in more patients who achieved a return of spontaneous circulation. Although survival rates to hospital admission and discharge did not differ, discharged patients who had been resuscitated with biphasic shocks were more likely to have good cerebral performance. (Circulation. 2000;102:1780-1787.) Key Words: defibrillation n resuscitation n heart arrest n heart-arrest device Sudden cardiac arrest associated with ventricular fibrilla-tion (VF) remains a leading cause of unexpected death in the Western world.1,2 Rapid-response programs3,4 with auto-