Influence of pH and hypoxia on the success of defibrillation

Clinical impressions about the problem of defibrillation during states of acid-base imbalance and hypoxia have been influenced by studies involving the effect of these derangements on the ventricular fibrillation threshold. Based on body weight, energy requirements for defibrillation in normal dogs were compared to requirements in dogs subjected to commonly encountered acid-base disturbances and severe hypoxemia. No significant differences were found. Seventy-five percent of all animals in the study were electrically converted with low-to-moderate levels of energy. The incidence of spontaneous resumption of circulation following defibrillation was lowest in animals subjected to metabolic acidosis and hypoxia. The results suggest that pH and blood gas alterations, previously shown to influence the normal ventricular fibrillation threshold, do not significantly affect the normal defibrillation threshold.