Comparison of defibrillation efficacy between two pads placements in a pediatric porcine model of cardiac arrest

Giuseppe Ristagno, Tao Yu, Weilun Quan, Gary Freeman, Yongqin Li

Research output: Contribution to journalArticle

Abstract

Objective: The placement of defibrillation pads at ideal anatomical sites is one of the major determinants of transthoracic defibrillation success. However, the optimal pads position for ventricular defibrillation is still undetermined. In the present study, we compared the effects of two different pads positions on defibrillation success rate in a pediatric porcine model of cardiac arrest. Methods: Eight domestic male pigs weighing 12-15. kg were randomized to receive shocks using either the anterior-posterior (AP) or the anterior-lateral (AL) position with pediatric pads. Ventricular fibrillation (VF) was electrically induced and untreated for 30. s. A sequence of randomized biphasic electrical shocks ranging from 10 to 100. J was attempted. If the defibrillation failed to terminate VF, a 100. J rescuer shock was then delivered. After a recovery interval of 5. min, the sequence was repeated for a total of approximately 30 test shocks were attempted for each animal. The dose response curves were constructed and the defibrillation thresholds were compared between groups. Results: The aggregated success rate was 65.6% for AP placement and 43.0% for AL one (p= 0.0005) when shock energy was between 10 and 70. J. A significantly lower 50% defibrillation threshold was obtained for AP pads placement compared with traditional AL pads position (2.1 ± 0.4. J/kg vs. 3.6 ± 0.9. J/kg, p= 0.041). Conclusion: In this pediatric porcine model of cardiac arrest, the anterior-posterior placement of pediatric pads yielded a higher success rate by lowering defibrillation threshold compared to the anterior-lateral position.

Original languageEnglish
Pages (from-to)755-759
Number of pages5
JournalResuscitation
Volume83
Issue number6
DOIs
Publication statusPublished - Jun 2012

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Heart Arrest
Shock
Swine
Pediatrics
Ventricular Fibrillation
Sus scrofa

Keywords

  • Anterior-lateral
  • Anterior-posterior
  • Cardiac arrest
  • Defibrillation efficacy
  • Pads placement
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Comparison of defibrillation efficacy between two pads placements in a pediatric porcine model of cardiac arrest. / Ristagno, Giuseppe; Yu, Tao; Quan, Weilun; Freeman, Gary; Li, Yongqin.

In: Resuscitation, Vol. 83, No. 6, 06.2012, p. 755-759.

Research output: Contribution to journalArticle

Ristagno, Giuseppe ; Yu, Tao ; Quan, Weilun ; Freeman, Gary ; Li, Yongqin. / Comparison of defibrillation efficacy between two pads placements in a pediatric porcine model of cardiac arrest. In: Resuscitation. 2012 ; Vol. 83, No. 6. pp. 755-759.
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AU - Li, Yongqin

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N2 - Objective: The placement of defibrillation pads at ideal anatomical sites is one of the major determinants of transthoracic defibrillation success. However, the optimal pads position for ventricular defibrillation is still undetermined. In the present study, we compared the effects of two different pads positions on defibrillation success rate in a pediatric porcine model of cardiac arrest. Methods: Eight domestic male pigs weighing 12-15. kg were randomized to receive shocks using either the anterior-posterior (AP) or the anterior-lateral (AL) position with pediatric pads. Ventricular fibrillation (VF) was electrically induced and untreated for 30. s. A sequence of randomized biphasic electrical shocks ranging from 10 to 100. J was attempted. If the defibrillation failed to terminate VF, a 100. J rescuer shock was then delivered. After a recovery interval of 5. min, the sequence was repeated for a total of approximately 30 test shocks were attempted for each animal. The dose response curves were constructed and the defibrillation thresholds were compared between groups. Results: The aggregated success rate was 65.6% for AP placement and 43.0% for AL one (p= 0.0005) when shock energy was between 10 and 70. J. A significantly lower 50% defibrillation threshold was obtained for AP pads placement compared with traditional AL pads position (2.1 ± 0.4. J/kg vs. 3.6 ± 0.9. J/kg, p= 0.041). Conclusion: In this pediatric porcine model of cardiac arrest, the anterior-posterior placement of pediatric pads yielded a higher success rate by lowering defibrillation threshold compared to the anterior-lateral position.

AB - Objective: The placement of defibrillation pads at ideal anatomical sites is one of the major determinants of transthoracic defibrillation success. However, the optimal pads position for ventricular defibrillation is still undetermined. In the present study, we compared the effects of two different pads positions on defibrillation success rate in a pediatric porcine model of cardiac arrest. Methods: Eight domestic male pigs weighing 12-15. kg were randomized to receive shocks using either the anterior-posterior (AP) or the anterior-lateral (AL) position with pediatric pads. Ventricular fibrillation (VF) was electrically induced and untreated for 30. s. A sequence of randomized biphasic electrical shocks ranging from 10 to 100. J was attempted. If the defibrillation failed to terminate VF, a 100. J rescuer shock was then delivered. After a recovery interval of 5. min, the sequence was repeated for a total of approximately 30 test shocks were attempted for each animal. The dose response curves were constructed and the defibrillation thresholds were compared between groups. Results: The aggregated success rate was 65.6% for AP placement and 43.0% for AL one (p= 0.0005) when shock energy was between 10 and 70. J. A significantly lower 50% defibrillation threshold was obtained for AP pads placement compared with traditional AL pads position (2.1 ± 0.4. J/kg vs. 3.6 ± 0.9. J/kg, p= 0.041). Conclusion: In this pediatric porcine model of cardiac arrest, the anterior-posterior placement of pediatric pads yielded a higher success rate by lowering defibrillation threshold compared to the anterior-lateral position.

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KW - Ventricular fibrillation

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