Immediate post-shock chest compressions improve outcome from prolonged ventricular fibrillation.
OBJECTIVE
This study was designed to test the hypothesis that immediate post-shock chest compressions improve outcome from prolonged ventricular fibrillation (VF) compared with typical "hands off" period (i.e., delayed post-shock compressions) associated with AED use.


METHODS
After 7.5 min of untreated VF, 36 domestic swine (26+/-1 kg) were treated with 200 J biphasic shocks and randomly assigned to: (1) 1 min of immediate post-shock chest compressions or (2) simulated pre-hospital automated external defibrillator (AED) care with delays in post-shock chest compressions. Return of spontaneous circulation (ROSC) occurred in 7/18 immediate chest compressions animals within 2 min of the first shock versus 0/18 AED animals (P<0.01). Ten of 18 immediate chest compressions animals attained ROSC compared with 3/18 AED animals (P<0.05). Nine of 18 immediate chest compressions swine were alive at 24 and 48 h compared with 3/18 AED swine (P<0.05). All 48-h survivors had good neurologic outcomes. Among the 21 animals that defibrillated with the first shock, ROSC was attained in 7/10 immediate chest compressions animals within 2 min of the first shock compared with 0/11 AED animals (P=0.001), and 48-h survival was attained in 8/10 versus 3/11, respectively (P<0.05).


CONCLUSIONS
Immediate post-shock chest compressions can substantially improve outcome from prolonged VF compared with simulated pre-hospital AED care.
Berg
Robert A
RA
The University of Arizona College of Medicine, Sarver Heart Center, Tucson, AZ 85724-5017, USA. rberg@email.arizona.edu
Hilwig
Ronald W
RW
Berg
Marc D
MD
Berg
David D
DD
Samson
Ricardo A
RA
Indik
Julia H
JH
Kern
Karl B
KB
D000818:Animals; D016009:Chi-Square Distribution; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D006336:Heart Massage / Q000379:methods*; D011897:Random Allocation; D013552:Swine; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000503:physiopathology / Q000628:therapy*