monophasic versus biphasic defibrillation for pediatric out-of-hospital cardiac arrest patients a nationwide population-based study in japan单相和两相的除颤对儿科心脏按压心脏骤停病人在日本全国性的以人群为基础的研究.pdfVIP

Tanabe et al. Critical Care 2012, 16:R219 /content/16/6/R219 RESEARCH Open Access Monophasic versus biphasic defibrillation for pediatric out-of-hospital cardiac arrest patients: a nationwide population-based study in Japan 1* 2 3 4 4 2 Seizan Tanabe , Hideo Yasunaga , Soichi Koike , Manabu Akahane , Toshio Ogawa , Hiromasa Horiguchi , Tetsuo Hatanaka5, Hiroyuki Yokota1 and Tomoaki Imamura4 Abstract Introduction: Conventional monophasic defibrillators for out-of-hospital cardiac-arrest patients have been replaced with biphasic defibrillators. However, the advantage of biphasic over monophasic defibrillation for pediatric out-of- hospital cardiac-arrest patients remains unknown. This study aimed to compare the survival outcomes of pediatric out-of-hospital cardiac-arrest patients who underwent monophasic defibrillation with those who underwent biphasic defibrillation. Methods: This prospective, nationwide, population-based observational study included pediatric out-of-hospital cardiac-arrest patients from January 1, 2005, to December 31, 2009. The primary outcome measure was survival at 1 month with minimal neurologic impairment. The secondary outcome measures were survival at 1 month and the return of spontaneous circulation before hospital arrival. Multivariable logistic regression analysis was performed to identify the independent association between defibrillator type (monophasic or biphasic) and outcomes. Results: Among 5,628 pediatric out-of-hospital cardiac-arrest patients (1 through 17 years old), 430 who received defibrillation shock with monophasic or biphasic defibrillator were analyzed. The number of patients who received defibrillation shock with monophasic defibrillator wa