@article{501f09d2d5724cc98888cf267ac7943b,
title = "The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial",
abstract = "Background: Previous research has demonstrated significant relationships between peri-shock pause and survival to discharge from out-of-hospital shockable cardiac arrest (OHCA). Objective: To determine the impact of peri-shock pause on survival from OHCA during the ROC PRIMED randomized controlled trial. Methods: We included patients in the ROC PRIMED trial who suffered OHCA between June 2007 and November 2009, presented with a shockable rhythm and had CPR process data for at least one shock. We used multivariable logistic regression to determine the association between peri-shock pause duration and survival to hospital discharge. Results: Among 2006 patients studied, the median (IQR) shock pause duration was: pre-shock pause 15. s (8, 22); post-shock pause 6. s (4, 9); and peri-shock pause 22.0. s (14, 31). After adjusting for Utstein predictors of survival as well as CPR quality measures, the odds of survival to hospital discharge were significantly higher for patients with pre-shock pause <10. s (OR: 1.52, 95% CI: 1.09, 2.11) and peri-shock pause <20. s (OR: 1.82, 95% CI: 1.17, 2.85) when compared to patients with pre-shock pause ≥20. s and peri-shock pause ≥40. s. Post-shock pause was not significantly associated with survival to hospital discharge. Results for neurologically intact survival (Modified Rankin Score. ≤. 3) were similar to our primary outcome. Conclusions: In patients with cardiac arrest presenting in a shockable rhythm during the ROC PRIMED trial, shorter pre- and peri-shock pauses were significantly associated with higher odds of survival. Future cardiopulmonary education and technology should focus on minimizing all peri-shock pauses.",
keywords = "Cardiopulmonary resuscitation, Heart arrest, Resuscitation, Survival",
author = "Sheldon Cheskes and Schmicker, {Robert H.} and Verbeek, {P. Richard} and Salcido, {David D.} and Brown, {Siobhan P.} and Steven Brooks and Menegazzi, {James J.} and Christian Vaillancourt and Judy Powell and Susanne May and Berg, {Robert A.} and Rebecca Sell and Ahamed Idris and Mike Kampp and Terri Schmidt and Jim Christenson",
note = "Funding Information: Drs. Cheskes, Christenson, Menegazzi, Idris as well as Susanne May and Judy Powell receive ROC grant funding. Dr. Brooks was supported by a Heart and Stroke Foundation Jumpstart Resuscitation Scholarship. Dr. Cheskes has received speaking honorarium from Zoll Medical. No other grant disclosures. Funding Information: The ROC is supported by a series of cooperative agreements to nine regional clinical centers and one Data Coordinating Center (5U01 HL077863 – University of Washington Data Coordinating Center, HL077866 – Medical College of Wisconsin, HL077867 – University of Washington, HL077871 – University of Pittsburgh, HL077872 – St. Michael's Hospital, HL077873 – Oregon Health and Science University, HL077881 – University of Alabama at Birmingham, HL077885 – Ottawa Hospital Research Institute, HL077887 – University of Texas SW Medical Ctr/Dallas, HL077908 – University of California San Diego) from the National Heart, Lung and Blood Institute in partnership with the National Institute of Neurological Disorders and Stroke , U.S. Army Medical Research & Material Command , The Canadian Institutes of Health Research (CIHR) – Institute of Circulatory and Respiratory Health, Defence Research and Development Canada and the Heart, Stroke Foundation of Canada and the American Heart Association . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung and Blood Institute or the National Institutes of Health. ",
year = "2014",
month = mar,
doi = "10.1016/j.resuscitation.2013.10.014",
language = "English (US)",
volume = "85",
pages = "336--342",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",
number = "3",
}