Related Experiment Video
Updated: Jul 13, 2025
Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
Published on: January 30, 2020
Out-of-hospital cardiac arrest treated with prehospital double sequential external defibrillation during eCPR in
Stephan Katzenschlager1, Raphael Heck2, Erik Popp2
1Heidelberg University, Medical Faculty Heidelberg, Department of Anesthesiology, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany. stephan.katzenschlager@med.uni-heidelberg.de.
Background:
Double sequential external defibrillation (DSED) has demonstrated increased survival with good neurological outcome in a recent randomized controlled trial. DSED has not been studied in patients with extracorporeal cardiopulmonary resuscitation (eCPR).
Case:
We present the first case of prehospital eCPR with ongoing refractory ventricular fibrillation (VF), terminated by DSED. After six shocks, return of spontaneous circulation was initially achieved; however, the patient went into recurrent VF. ECPR was performed prehospital, with VF still refractory after three more shocks. DSED successfully terminated VF and showed a further increase in etCO2 and near-infrared spectroscopy cerebral oximetry values.
Conclusion:
DSED can be a sufficient strategy for patients in refractory VF while on eCPR and should be evaluated in further studies.
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