title: 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. Optimized Response to Cardiac Arrest (ORCA) Investigators.
abstract: 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.
  
  
  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 8.9+/-3.0 (mean+/-SD) 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.
authors.affiliation: Johannes Gutenberg-Universitaet, Mainz, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Schneider
authors.forename: P R
authors.initials: PR
authors.lastname: Martens
authors.forename: H
authors.initials: H
authors.lastname: Paschen
authors.forename: M
authors.initials: M
authors.lastname: Kuisma
authors.forename: B
authors.initials: B
authors.lastname: Wolcke
authors.forename: B E
authors.initials: BE
authors.lastname: Gliner
authors.forename: J K
authors.initials: JK
authors.lastname: Russell
authors.forename: W D
authors.initials: WD
authors.lastname: Weaver
authors.forename: L
authors.initials: L
authors.lastname: Bossaert
authors.forename: D
authors.initials: D
authors.lastname: Chamberlain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011930:Reaction Time; D015996:Survival Rate; D016896:Treatment Outcome