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Crit Care Med. 2004 Sep;32(9 Suppl):S387-92.

Body weight does not affect defibrillation, resuscitation, or survival in patients with out-of-hospital cardiac arrest treated with a nonescalating biphasic waveform defibrillator.

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1
The Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

Abstract

BACKGROUND:

This is a study of the influence of body weight on defibrillation, resuscitation, and survival in patients with out-of-hospital cardiac arrest treated with a nonescalating impedance-compensating 150-J biphasic waveform defibrillator.

METHODS:

Cardiac arrest data from Rochester, MN, emergency medical services over a 6-yr period was retrospectively analyzed. Patient weight data were available for 62 of the 68 patients who were treated initially by basic life support personnel and who presented with a shockable rhythm. For each defibrillation and resuscitation outcome variable, we tested for differences in body weight for successful vs. unsuccessful outcome.

RESULTS:

Initial shocks defibrillated 92% (83% to 97%) of patients. Cumulative success with two shocks was 98% (confidence interval, 92% to 100%) and with three shocks was 100% (confidence interval, 95% to 100%). The mean shock impedance was 90 +/- 21 ohms. The average body weight was 84 +/- 17 kg (minimum, 53 kg; maximum, 135 kg) and was normally distributed. Based on the body mass index for 46 patients, approximately 41% were classified as overweight (body mass index, > or = 25), 24% obese (body mass index, > or = 30), and 4% extremely obese (body mass index, > or = 40). The remaining 31% were classified as normal or underweight. First-shock success, cumulative success through two shocks, and cumulative success through the first-shock series were unrelated to body weight, as were basic life support restoration of spontaneous circulation, prehospital restoration of spontaneous circulation, hospital admission, and discharge.

CONCLUSIONS:

Overweight patients were defibrillated by the biphasic waveform used in this study at high rates, with a fixed energy of 150 J, and without energy escalation.

PMID:
15508666
[Indexed for MEDLINE]

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