The Effects of Public Access Defibrillation on Survival After Out-of-Hospital Cardiac Arrest

Ovid Technologies (Wolters Kluwer Health) - Tập 136 Số 10 - Trang 954-965 - 2017
Josefine S. Bækgaard1, Søren Viereck1, Thea Palsgaard Møller1, Annette Kjær Ersbøll1, Freddy Lippert1,2, Fredrik Folke1,2
1From Emergency Medical Services Copenhagen, University of Copenhagen, Denmark (J.S.B., S.V., T.P.M., F.L., F.F.); and National Institute of Public Health, University of Southern Denmark, Copenhagen (A.K.E.).
2National Institute of Public Health, University of Southern Denmark, Copenhagen (A.K.E.).

Tóm tắt

Background: Despite recent advances, the average survival after out-of-hospital cardiac arrest (OHCA) remains <10%. Early defibrillation by an automated external defibrillator is the most important intervention for patients with OHCA, showing survival proportions >50%. Accordingly, placement of automated external defibrillators in the community as part of a public access defibrillation program (PAD) is recommended by international guidelines. However, different strategies have been proposed on how exactly to increase and make use of publicly available automated external defibrillators. This systematic review aimed to evaluate the effect of PAD and the different PAD strategies on survival after OHCA. Methods: PubMed, Embase, and the Cochrane Library were systematically searched on August 31, 2015 for observational studies reporting survival to hospital discharge in OHCA patients where an automated external defibrillator had been used by nonemergency medical services. PAD was divided into 3 groups according to who applied the defibrillator: nondispatched lay first responders, professional first responders (firefighters/police) dispatched by the Emergency Medical Dispatch Center (EMDC), or lay first responders dispatched by the EMDC. Results: A total of 41 studies were included; 18 reported PAD by nondispatched lay first responders, 20 reported PAD by EMDC-dispatched professional first responders (firefighters/police), and 3 reported both. We identified no qualified studies reporting survival after PAD by EMDC-dispatched lay first responders. The overall survival to hospital discharge after OHCA treated with PAD showed a median survival of 40.0% (range, 9.1–83.3). Defibrillation by nondispatched lay first responders was associated with the highest survival with a median survival of 53.0% (range, 26.0–72.0), whereas defibrillation by EMDC-dispatched professional first responders (firefighters/police) was associated with a median survival of 28.6% (range, 9.0–76.0). A meta-analysis of the different survival outcomes could not be performed because of the large heterogeneity of the included studies. Conclusions: This systematic review showed a median overall survival of 40% for patients with OHCA treated by PAD. Defibrillation by nondispatched lay first responders was found to correlate with the highest impact on survival in comparison with EMDC-dispatched professional first responders. PAD by EMDC-dispatched lay first responders could be a promising strategy, but evidence is lacking.

Từ khóa


Tài liệu tham khảo

10.1161/CIR.0000000000000366

10.1016/j.resuscitation.2005.03.021

10.1161/CIRCOUTCOMES.109.889576

10.1016/j.resuscitation.2010.08.006

10.1016/j.resuscitation.2016.06.004

10.1016/S0196-0644(05)81302-2

10.1001/jama.2013.278483

10.1016/j.resuscitation.2015.07.015

10.1161/CIRCULATIONAHA.114.010905

10.1161/CIRCULATIONAHA.110.015545

10.1056/NEJM200010263431701

10.1056/NEJMoa1406038

10.3109/10903127.2013.825353

10.1186/1757-7241-17-16

10.1161/CIR.0000000000000258

TrygFonden Web site. https://hjertestarter.dk/. Accessed June 21 2016.

10.1016/j.resuscitation.2007.11.019

10.1016/j.resuscitation.2008.03.226

10.1056/NEJMoa0906644

10.1161/CIRCULATIONAHA.114.008850

State Laws on Cardiac Arrest and Defibrillators. http://www.ncsl.org/research/health/laws-on-cardiac-arrest-and-defibrillators-aeds.aspx#2. Accessed June 21 2016.

10.1016/j.jacc.2009.11.077

10.1371/journal.pmed.1000097

PRISMA. http://www.prisma-statement.org/Endorsement/PRISMAEndorsers.aspx#w. Accessed June 21 2016.

PROSPERO - International prospective register of systematic reviews. http://www.crd.york.ac.uk/PROSPERO. Accessed June 21 2016.

O’Connor D, Green S, Higgins JPT. Chapter 5: Defining the review questions and developing criteria for including studies. The Cochrane Collaboration. , Higgins JPT, Green S, eds. In: Cochrane Handbook for Systematic Reviews of Interventions. 2011. http://handbook.cochrane.org. Accessed June 21, 2016.

O’Connor D, Green S, Higgins JPT. Chapter 7: Selecting studies and collecting data. Table 7.7.a: Formulae for combining groups. The Cochrane Collaboration. , Higgins JPT, Green S, eds. In: Cochrane Handbook for Systematic Reviews of Interventions. 2011. http://handbook.cochrane.org/chapter_7/table_7_7_a_formulae_for_combining_groups.htm. Accessed June 21, 2016.

Wells GA Shea B O’Connell D Peterson J Welch V Losos M Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2016. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed June 21 2016.

9.1.4 When not to use meta-analysis in a review. http://handbook.cochrane.org/chapter_9/9_1_4_when_not_to_use_meta_analysis_in_a_review.htm. Accessed February 1 2017.

10.1016/j.resuscitation.2004.05.011

10.1056/NEJMoa020932

10.1136/bjsports-2013-092786

10.1016/j.resuscitation.2012.03.029

10.1017/S1049023X0000025X

10.1016/j.resuscitation.2012.09.033

10.1097/JOM.0000000000000042

10.1016/j.resuscitation.2014.10.005

10.1016/j.hrthm.2012.10.034

McNally B, Robb R, Mehta M, Vellano K, Valderrama AL, Yoon PW, Sasson C, Crouch A, Perez AB, Merritt R, Kellermann A; Centers for Disease Control and Prevention. Out-of-hospital cardiac arrest surveillance—Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005–December 31, 2010. MMWR Surveill Summ. 2011;60:1–19.

10.1016/j.resuscitation.2014.08.038

10.1001/jama.2015.8068

10.1161/01.CIR.96.9.2849

10.5694/j.1326-5377.2007.tb01083.x

10.1056/NEJM200010263431702

10.1016/S0300-9572(01)00430-0

10.1111/j.1553-2712.2001.tb02109.x

10.1001/jama.2015.7938

10.1080/10903120290938689

10.1016/S0196-0644(98)70137-4

10.1016/S0300-9572(03)00178-3

10.1016/j.resuscitation.2013.02.023

10.1161/CIRCULATIONAHA.105.537282

10.1016/j.resuscitation.2004.10.018

10.1161/01.CIR.69.5.943

10.1111/j.1540-8159.1993.tb01578.x

10.1056/NEJM198809153191101

10.1016/j.resuscitation.2014.10.010

10.1067/S0196064403003834

10.1161/01.cir.0000028148.62305.69

10.1016/S0196-0644(05)81304-6

10.1016/S0300-9572(03)00183-7

10.1017/S1049023X0003781X

10.1016/j.resuscitation.2015.02.032

10.1161/CIR.0000000000000350

Centers for Disease Control and Prevention. 2014 Cardiac Arrest Registry to Enhance Survival (CARES) National Summary Report. 2016. https://mycares.net/sitepages/uploads/2015/2014%20Non-Traumatic%20National%20Summary%20Report.pdf. Accessed June 21 2016.

10.1161/01.CIR.96.10.3308

10.1056/NEJMoa040566

10.1016/j.resuscitation.2014.07.020

10.1016/S0300-9572(02)00442-2

2014 Non-Traumatic National Summary Report.pdf. https://mycares.net/sitepages/uploads/2015/2014%20Non-Traumatic%20National%20Summary%20Report.pdf. ACcessed June 21 2016.

10.1056/NEJMoa1010663

PulsePoint. http://www.pulsepoint.org/app. Accessed June 21 2016.

GoodSAM. https://www.goodsamapp.org/home. Accessed June 21 2016.

Can Dispatcher-Activated Neighborhood Access Defibrillation and Cardiopulmonary Resuscitation Improve Survival of out-of Hospital Cardiac Arrest? ClinicalTrials.gov Identifier: NCT02010151. https://clinicaltrials.gov/ct2/show/NCT02010151?term=Out-of-hospital+cardiac+arrest&rank=17. Accessed June 21 2016.

10.1016/j.resuscitation.2014.11.002

10.1161/CIRCULATIONAHA.114.011366

Thông tin
Thông tin xuất bản

Ovid Technologies (Wolters Kluwer Health)

Tập 136 Số 10

954-965

Thông tin tác giả