Double Defibrillation for Refractory In- and Out-of-Hospital Cardiac Arrest : A Systematic Review and Meta-Analysis
Copyright © 2020 Elsevier Inc. All rights reserved..
BACKGROUND: Double/dual defibrillation (DD) has been proposed as an alternative treatment for refractory ventricular fibrillation (VF). This topic has been poorly researched and data on survival rates are limited.
OBJECTIVE: This systematic review and meta-analysis evaluates whether DD improves outcomes among patients with refractory VF in- and out-of-hospital cardiac arrest compared with standard defibrillation.
METHODS: A literature search was conducted on July 20, 2019 using MEDLINE via PubMed, Embase, Scopus, and the Cochrane Database of Systematic Reviews. We gave all results as a pooled odds ratio (OR) and 95% confidence interval (CI). Heterogeneity was assessed by calculating the I2 statistic and was deemed significant for a p value of < 0.10 or I2 ≥ 50%. The quality of evidence was evaluated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines.
RESULTS: We included 27 records, of which 4 cohort studies totaling 1061 patients were included in the quantitative analysis. Of these, 20.5% (n = 217) received the intervention. DD had no effect on return of spontaneous circulation (OR 0.68; 95% CI 0.44-1.04; I2 = 41%, p = 0.08) (GRADE: Very low), survival to admission (OR 0.77; 95% CI 0.51-1.17; I2 = 18%, p = 0.22) (GRADE: Very low), or survival to discharge (OR 0.66; 95% CI 0.38-1.15; I2 = 0%, p = 0.14) (GRADE: Very low).
CONCLUSIONS: DD did not improve any outcomes of interest. Therefore, it is imperative that a well-designed study in this area be conducted. Ideally, conducting a randomized controlled trial in this population should be attempted to obtain a higher level of scientific evidence.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:59 |
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| Enthalten in: |
The Journal of emergency medicine - 59(2020), 4 vom: 24. Okt., Seite 521-541 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Miraglia, Dennis [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 23.06.2021 Date Revised 23.06.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jemermed.2020.06.024 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM313124922 |
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| 500 | |a Date Revised 23.06.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Double/dual defibrillation (DD) has been proposed as an alternative treatment for refractory ventricular fibrillation (VF). This topic has been poorly researched and data on survival rates are limited | ||
| 520 | |a OBJECTIVE: This systematic review and meta-analysis evaluates whether DD improves outcomes among patients with refractory VF in- and out-of-hospital cardiac arrest compared with standard defibrillation | ||
| 520 | |a METHODS: A literature search was conducted on July 20, 2019 using MEDLINE via PubMed, Embase, Scopus, and the Cochrane Database of Systematic Reviews. We gave all results as a pooled odds ratio (OR) and 95% confidence interval (CI). Heterogeneity was assessed by calculating the I2 statistic and was deemed significant for a p value of < 0.10 or I2 ≥ 50%. The quality of evidence was evaluated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines | ||
| 520 | |a RESULTS: We included 27 records, of which 4 cohort studies totaling 1061 patients were included in the quantitative analysis. Of these, 20.5% (n = 217) received the intervention. DD had no effect on return of spontaneous circulation (OR 0.68; 95% CI 0.44-1.04; I2 = 41%, p = 0.08) (GRADE: Very low), survival to admission (OR 0.77; 95% CI 0.51-1.17; I2 = 18%, p = 0.22) (GRADE: Very low), or survival to discharge (OR 0.66; 95% CI 0.38-1.15; I2 = 0%, p = 0.14) (GRADE: Very low) | ||
| 520 | |a CONCLUSIONS: DD did not improve any outcomes of interest. Therefore, it is imperative that a well-designed study in this area be conducted. Ideally, conducting a randomized controlled trial in this population should be attempted to obtain a higher level of scientific evidence | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a double defibrillation | |
| 650 | 4 | |a double sequential defibrillation | |
| 650 | 4 | |a double simultaneous defibrillation | |
| 650 | 4 | |a dual defibrillation | |
| 650 | 4 | |a in-hospital cardiac arrest | |
| 650 | 4 | |a out-of-hospital cardiac arrest | |
| 650 | 4 | |a refractory ventricular fibrillation | |
| 700 | 1 | |a Miguel, Lourdes A |e verfasserin |4 aut | |
| 700 | 1 | |a Alonso, Wilfredo |e verfasserin |4 aut | |
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