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Biphasic defibrillation does not improve outcomes compared to monophasic defibrillation in out-of-hospital cardiac

Kimberly Freeman1, Gregory W Hendey, Marc Shalit

  • 1Department of Emergency Medicine, UCSF-Fresno, Medical Education Program, Fresno, California 93701-2302, USA.

Prehospital Emergency Care
|April 2, 2008
PubMed

Insights

This study found no significant difference in survival for out-of-hospital cardiac arrest (OHCA) patients treated with monophasic truncated exponential (MTE) or biphasic truncated exponential (BTE) defibrillation. However, BTE defibrillation required fewer shocks to achieve return of spontaneous circulation (ROSC).

Area of Science:

  • Emergency Medicine
  • Cardiology
  • Critical Care

Background:

  • Out-of-hospital cardiac arrest (OHCA) remains a critical public health issue.
  • Defibrillation waveform type is a key factor in advanced cardiac life support protocols.

Purpose of the Study:

  • To compare the effectiveness of monophasic truncated exponential (MTE) versus biphasic truncated exponential (BTE) defibrillation for OHCA patients.
  • To evaluate outcomes including return of spontaneous circulation (ROSC), survival to discharge, and defibrillation success rates.

Main Methods:

  • Retrospective review of 485 OHCA patient records from August 2000 to July 2004.
  • Analysis of prehospital and hospital data comparing MTE and BTE defibrillation groups.
  • Key outcome measures included ROSC, survival to discharge, and number of defibrillations.

Main Results:

  • No significant difference in ROSC rates between MTE (30.6%) and BTE (30.0%) groups (p=0.92).
  • Survival to hospital discharge was similar: 12.3% for MTE and 10.3% for BTE (p=0.57).
  • Fewer defibrillations were required to achieve ROSC with BTE (2.6) compared to MTE (3.5) (p=0.015).

Conclusions:

  • MTE and BTE defibrillation show comparable efficacy for OHCA in terms of ROSC and survival.
  • BTE defibrillation may be more efficient, requiring fewer shocks for successful resuscitation.
  • Further research could explore optimal BTE energy levels and protocols.
Abstract

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