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• W2003638902 abstract "<h2>Abstract</h2><h3>Background</h3> In advanced life support (ALS), time-cycled loops of chest compressions form the basis of action. However, the provider must compromise between interrupting compressions and detecting a change in cardiac rhythm. An optimal loop duration would best balance these choices. The current international CPR guidelines recommend 2-min loop durations. The aim of this study was to investigate the optimal loop duration in patients with initial asystole or pulseless electrical activity (PEA). <h3>Materials and methods</h3> Detailed defibrillator recordings from 249 in-hospital cardiac arrests at the University of Chicago Medicine (Chicago, IL) and St. Olav University Hospital (Trondheim, Norway) were analysed. The clinical states of asystole, PEA, ventricular fibrillation/-tachycardia (VF/VT) and return of spontaneous circulation (ROSC) were annotated along the time axis. PEA and asystole were combined as a single state for the analysis of state development. The probability of staying in PEA/asystole over time was estimated non-parametrically. In addition, to distinguish between initial and secondary PEA/asystole, the latter was defined by the transition from VF/VT or ROSC. <h3>Results</h3> Among patients with initial PEA (<i>n</i>=179), 25% and 50% of patients had left PEA/asystole after 4 and 9min of ALS efforts, respectively. The corresponding time points for patients with initial asystole (<i>n</i>=70) were 7.3 and 13.3min, respectively. The probability of transition from secondary PEA/asystole to ROSC or VF/VT varied between 10% and 20% in each 2–4min interval. <h3>Conclusion</h3> The optimal first loop duration may be 4min in initial PEA and 6–8min in initial asystole. If secondary PEA/asystole is encountered, 2-min loop duration seems appropriate." @default.
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• W2003638902 date "2014-01-01" @default.
• W2003638902 modified "2023-10-16" @default.
• W2003638902 title "Optimal loop duration during the provision of in-hospital advanced life support (ALS) to patients with an initial non-shockable rhythm" @default.
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• W2003638902 doi "https://doi.org/10.1016/j.resuscitation.2013.08.261" @default.
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