Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation: Retrospective analysis of prospectively collected prehospital data

Dong Keon Lee, Yu Jin Kim, Giwoon Kim, Choung Ah Lee, Hyung Jun Moon, Jaehoon Oh, Hae Chul Yang, Han Joo Choi, Young Taeck Oh, Seung Min Park

Research output: Contribution to journalArticle

Abstract

Background: The 2015 AHA guidelines recommend that amiodarone should be used for patients with refractory ventricular fibrillation (RVF). However, the optimal time interval between the incoming call and amiodarone administration (call-to-amiodarone administration interval) in RVF patients has not been investigated. We hypothesized that the time elapsed until amiodarone administration could affect the neurological outcome at hospital discharge in patients with RVF. Methods and results: This study is a retrospective analysis of prospectively collected data. One hundred thirty-four patients were enrolled. In univariate logistic regression, the probability of a good neurological outcome at hospital discharge decreased as the time elapsed until amiodarone administration increased (OR 0.89 [95% CI = 0.80-0.99]). In multivariate logistic regression, the patients who were administered amiodarone in less than 20 min showed higher rates of prehospital ROSC, survival at hospital arrival, any ROSC, survival at admission, survival to discharge, and good CPC at hospital discharge. The call-to-amiodarone administration interval of ≤20 min (OR 6.92, 95% CI 1.72-27.80) was the independent factor affecting the neurological outcome at hospital discharge. Conclusion: Early amiodarone administration (≤ 20 min) showed better neurological outcome at hospital discharge for OHCA patients who showed initial ventricular fibrillation and subsequent RVF.

Original languageEnglish
Article number109
JournalScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Volume27
Issue number1
DOIs
StatePublished - 10 Dec 2019

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Amiodarone
Ventricular Fibrillation
Intravenous Administration
Patient Discharge
Survival
Logistic Models
Guidelines

Keywords

  • Amiodarone
  • Cardiopulmonary resuscitation
  • Emergency medical services
  • Prognosis
  • Ventricular fibrillation

Cite this

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title = "Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation: Retrospective analysis of prospectively collected prehospital data",
abstract = "Background: The 2015 AHA guidelines recommend that amiodarone should be used for patients with refractory ventricular fibrillation (RVF). However, the optimal time interval between the incoming call and amiodarone administration (call-to-amiodarone administration interval) in RVF patients has not been investigated. We hypothesized that the time elapsed until amiodarone administration could affect the neurological outcome at hospital discharge in patients with RVF. Methods and results: This study is a retrospective analysis of prospectively collected data. One hundred thirty-four patients were enrolled. In univariate logistic regression, the probability of a good neurological outcome at hospital discharge decreased as the time elapsed until amiodarone administration increased (OR 0.89 [95{\%} CI = 0.80-0.99]). In multivariate logistic regression, the patients who were administered amiodarone in less than 20 min showed higher rates of prehospital ROSC, survival at hospital arrival, any ROSC, survival at admission, survival to discharge, and good CPC at hospital discharge. The call-to-amiodarone administration interval of ≤20 min (OR 6.92, 95{\%} CI 1.72-27.80) was the independent factor affecting the neurological outcome at hospital discharge. Conclusion: Early amiodarone administration (≤ 20 min) showed better neurological outcome at hospital discharge for OHCA patients who showed initial ventricular fibrillation and subsequent RVF.",
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Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation : Retrospective analysis of prospectively collected prehospital data. / Lee, Dong Keon; Kim, Yu Jin; Kim, Giwoon; Lee, Choung Ah; Moon, Hyung Jun; Oh, Jaehoon; Yang, Hae Chul; Choi, Han Joo; Oh, Young Taeck; Park, Seung Min.

In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol. 27, No. 1, 109, 10.12.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation

T2 - Retrospective analysis of prospectively collected prehospital data

AU - Lee, Dong Keon

AU - Kim, Yu Jin

AU - Kim, Giwoon

AU - Lee, Choung Ah

AU - Moon, Hyung Jun

AU - Oh, Jaehoon

AU - Yang, Hae Chul

AU - Choi, Han Joo

AU - Oh, Young Taeck

AU - Park, Seung Min

PY - 2019/12/10

Y1 - 2019/12/10

N2 - Background: The 2015 AHA guidelines recommend that amiodarone should be used for patients with refractory ventricular fibrillation (RVF). However, the optimal time interval between the incoming call and amiodarone administration (call-to-amiodarone administration interval) in RVF patients has not been investigated. We hypothesized that the time elapsed until amiodarone administration could affect the neurological outcome at hospital discharge in patients with RVF. Methods and results: This study is a retrospective analysis of prospectively collected data. One hundred thirty-four patients were enrolled. In univariate logistic regression, the probability of a good neurological outcome at hospital discharge decreased as the time elapsed until amiodarone administration increased (OR 0.89 [95% CI = 0.80-0.99]). In multivariate logistic regression, the patients who were administered amiodarone in less than 20 min showed higher rates of prehospital ROSC, survival at hospital arrival, any ROSC, survival at admission, survival to discharge, and good CPC at hospital discharge. The call-to-amiodarone administration interval of ≤20 min (OR 6.92, 95% CI 1.72-27.80) was the independent factor affecting the neurological outcome at hospital discharge. Conclusion: Early amiodarone administration (≤ 20 min) showed better neurological outcome at hospital discharge for OHCA patients who showed initial ventricular fibrillation and subsequent RVF.

AB - Background: The 2015 AHA guidelines recommend that amiodarone should be used for patients with refractory ventricular fibrillation (RVF). However, the optimal time interval between the incoming call and amiodarone administration (call-to-amiodarone administration interval) in RVF patients has not been investigated. We hypothesized that the time elapsed until amiodarone administration could affect the neurological outcome at hospital discharge in patients with RVF. Methods and results: This study is a retrospective analysis of prospectively collected data. One hundred thirty-four patients were enrolled. In univariate logistic regression, the probability of a good neurological outcome at hospital discharge decreased as the time elapsed until amiodarone administration increased (OR 0.89 [95% CI = 0.80-0.99]). In multivariate logistic regression, the patients who were administered amiodarone in less than 20 min showed higher rates of prehospital ROSC, survival at hospital arrival, any ROSC, survival at admission, survival to discharge, and good CPC at hospital discharge. The call-to-amiodarone administration interval of ≤20 min (OR 6.92, 95% CI 1.72-27.80) was the independent factor affecting the neurological outcome at hospital discharge. Conclusion: Early amiodarone administration (≤ 20 min) showed better neurological outcome at hospital discharge for OHCA patients who showed initial ventricular fibrillation and subsequent RVF.

KW - Amiodarone

KW - Cardiopulmonary resuscitation

KW - Emergency medical services

KW - Prognosis

KW - Ventricular fibrillation

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U2 - 10.1186/s13049-019-0688-1

DO - 10.1186/s13049-019-0688-1

M3 - Article

C2 - 31823800

AN - SCOPUS:85076353664

VL - 27

JO - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

JF - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

SN - 1757-7241

IS - 1

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