The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial

• Published in: Resuscitation 2014-03, Vol.85 (3), p.336-342
• Main Authors: Cheskes, Sheldon, Schmicker, Robert H, Verbeek, P. Richard, Salcido, David D, Brown, Siobhan P, Brooks, Steven, Menegazzi, James J, Vaillancourt, Christian, Powell, Judy, May, Susanne, Berg, Robert A, Sell, Rebecca, Idris, Ahamed, Kampp, Mike, Schmidt, Terri, Christenson, Jim
• Format: Article
• Language: English
• Subjects: Aged; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Emergency; Female; Heart arrest; Humans; Male; Middle Aged; Out-of-Hospital Cardiac Arrest - mortality; Out-of-Hospital Cardiac Arrest - therapy; Resuscitation; Survival; Survival Rate; Time Factors; Treatment Outcome
• ISSN: 0300-9572; 1873-1570; 1873-1570
• DOI: 10.1016/j.resuscitation.2013.10.014

Abstract Background Previous research has demonstrated significant relationships between peri-shock pause and survival to discharge from out-of-hospital shockable cardiac arrest (OHCA). Objective To determine the impact of peri-shock pause on survival from OHCA during the ROC PRIMED randomized controlled trial. Methods We included patients in the ROC PRIMED trial who suffered OHCA between June 2007 and November 2009, presented with a shockable rhythm and had CPR process data for at least one shock. We used multivariable logistic regression to determine the association between peri-shock pause duration and survival to hospital discharge. Results Among 2006 patients studied, the median (IQR) shock pause duration was: pre-shock pause 15 s (8, 22); post-shock pause 6 s (4, 9); and peri-shock pause 22.0 s (14, 31). After adjusting for Utstein predictors of survival as well as CPR quality measures, the odds of survival to hospital discharge were significantly higher for patients with pre-shock pause