Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrest

Objective: This study aims to quantify the reliability of automated external defibrillators (AED) in paediatric out-of-hospital cardiac arrests (pOHCA) by evaluating the defibrillation and the shock advisory system efficacy. Furthermore, the relationship between the initial energy dose and patient o...

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Main Authors: Emma Menant, Delphine Lavignasse, Sarah Ménétré, Jean-Philippe Didon, Xavier Jouven
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Resuscitation Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666520425000104
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author Emma Menant
Delphine Lavignasse
Sarah Ménétré
Jean-Philippe Didon
Xavier Jouven
author_facet Emma Menant
Delphine Lavignasse
Sarah Ménétré
Jean-Philippe Didon
Xavier Jouven
author_sort Emma Menant
collection DOAJ
description Objective: This study aims to quantify the reliability of automated external defibrillators (AED) in paediatric out-of-hospital cardiac arrests (pOHCA) by evaluating the defibrillation and the shock advisory system efficacy. Furthermore, the relationship between the initial energy dose and patient outcomes is analysed. Methods: We studied data from all pOHCA cases (age < 18 years) treated by the Paris Fire Brigade between January 2010 and December 2018, limited to those with available AED signals. The efficacy of shocks is the primary outcome. The secondary outcomes are the shock advisory system performance, pre-hospital return of a spontaneous circulation (ROSC), survival and energy dose. Energy dose, weight and age are compared using a Wilcoxon test according to the outcome’s values. Results: A total of 1,990 electrocardiogram strips extracted from 349 pOHCA cases were included in the study. Shock advisory system had a sensitivity of 89.4% and a specificity of 99.8% for the detection of shockable rhythms. Shock efficacy observed for all patients who received a shock was 83.1% and first shock efficacy for patients in initial ventricular fibrillation was 96%. Patients who received a shock had a pre-hospital ROSC rate of 74.3%, a survival rate at hospital admission of 71.4% and 34.3% at hospital discharge. Conclusion: This study shows that AED detect shockable rhythm with a good sensitivity and specificity and that shocks are associated with a very high rates of termination of shockable rhythms in pOHCA.
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spelling doaj-art-ce00af5206b44b4eb2ef61db74d71a852025-01-26T05:05:07ZengElsevierResuscitation Plus2666-52042025-03-0122100873Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrestEmma Menant0Delphine Lavignasse1Sarah Ménétré2Jean-Philippe Didon3Xavier Jouven4Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015 France; Corresponding author.Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015 FranceSchiller Médical SAS, 4 rue L. Pasteur 67160 Wissembourg, FranceSchiller Médical SAS, 4 rue L. Pasteur 67160 Wissembourg, FranceUniversité Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015 FranceObjective: This study aims to quantify the reliability of automated external defibrillators (AED) in paediatric out-of-hospital cardiac arrests (pOHCA) by evaluating the defibrillation and the shock advisory system efficacy. Furthermore, the relationship between the initial energy dose and patient outcomes is analysed. Methods: We studied data from all pOHCA cases (age < 18 years) treated by the Paris Fire Brigade between January 2010 and December 2018, limited to those with available AED signals. The efficacy of shocks is the primary outcome. The secondary outcomes are the shock advisory system performance, pre-hospital return of a spontaneous circulation (ROSC), survival and energy dose. Energy dose, weight and age are compared using a Wilcoxon test according to the outcome’s values. Results: A total of 1,990 electrocardiogram strips extracted from 349 pOHCA cases were included in the study. Shock advisory system had a sensitivity of 89.4% and a specificity of 99.8% for the detection of shockable rhythms. Shock efficacy observed for all patients who received a shock was 83.1% and first shock efficacy for patients in initial ventricular fibrillation was 96%. Patients who received a shock had a pre-hospital ROSC rate of 74.3%, a survival rate at hospital admission of 71.4% and 34.3% at hospital discharge. Conclusion: This study shows that AED detect shockable rhythm with a good sensitivity and specificity and that shocks are associated with a very high rates of termination of shockable rhythms in pOHCA.http://www.sciencedirect.com/science/article/pii/S2666520425000104Paediatric out-of-hospital cardiac arrestAutomated external defibrillatorShock efficacyShock advisory systemSurvivalEnergy dose
spellingShingle Emma Menant
Delphine Lavignasse
Sarah Ménétré
Jean-Philippe Didon
Xavier Jouven
Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrest
Resuscitation Plus
Paediatric out-of-hospital cardiac arrest
Automated external defibrillator
Shock efficacy
Shock advisory system
Survival
Energy dose
title Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrest
title_full Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrest
title_fullStr Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrest
title_full_unstemmed Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrest
title_short Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrest
title_sort automated external defibrillator rhythm analysis and defibrillation on paediatric out of hospital cardiac arrest
topic Paediatric out-of-hospital cardiac arrest
Automated external defibrillator
Shock efficacy
Shock advisory system
Survival
Energy dose
url http://www.sciencedirect.com/science/article/pii/S2666520425000104
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