Effect of the conversion from initial non-shockable rhythm to shockable rhythm during mechanical chest compressions on the prognosis in out-of-hospital cardiac arrest adults
Jing Daoyuan
Lu Ying
Zhao Junlu
Tang Hanqi
Zhang Bingwen
Kong Laifa
Xu Jun
Abstract：Objective To analyze the effect of the conversion from initial non-shockable rhythm to shockable rhythm(shockable rhythm conversion,SRC)during mechanical chest compressions on the prognosis in out-of-hospital cardiac arrest(OHCA)adults.Methods The data of OHCA adults with initial non-shockable rhythm in the Emergency Department of Jinhua Municipal Central Hospital between January 2021 and December 2022 were retrospectively analyzed.Following admission,all the patients underwent mechanical chest compressions with multifunctional electrode pads for continuous monitoring and defibrillation purposes,as well as early tracheal intubation to facilitate mechanical ventilation.The patients with initial non-shockable rhythm were divided into two groups based on whether the patients converted to a shockable rhythm during cardiopulmonary resuscitation(CPR).The differences in return of spontaneous circulation(ROSC)rate,the rate of survival at hospital discharge with favorable neurological status,4-hour and 28-day survival rates were compared.Results A total of 247 OHCA patients with initial non-shockable rhythms were included.There were 40 cases in the SRC group and 207 cases in the Non-SRC group.The ROSC rate(47.5％vs.20.8％),4-hour survival rate(22.5％vs.9.2％)and 28-day survival rate(17.5％vs.6.3％)were significantly higher in the SRC group compared with the Non-SRC group(P＜0.05).There was no significant difference in the rate of survival at hospital discharge with favorable neurological status between two groups.Conclusions The presence of SRC during mechanical chest compressions in OHCA adults with initial non-shockable rhythm significantly improves ROSC rate and survival rate.
Keywords：Out-of-hospital cardiac arrestInitial rhythmsNon-shockable rhythmShockable rhythmCardiopulmonary resuscitationReturn of spontaneous circulationOutcomes
Publication Date：2024-11-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 977-980 )