Acute cardiac care & resuscitation
Clinical state transitions in shock-refractory ventricular fibrillation: an observational study
Authors' conclusion
Understanding clinical state transitions during the resuscitation of refractory VF/pVT patients may allow for the development of tailored treatment strategies.
Study context
- Population
- Refractory VF/pVT out-of-hospital cardiac arrest (OHCA) cases treated by emergency medical services (EMS) between 2010 and 2019 in Victoria, Australia (initial VF/pVT arrests with at least three consecutive defibrillation attempts)cases met the inclusion criteria
- Participants
- 3,018 cases
- Exposure
- Clinical state transitions and their association with clinical outcomes
Main finding
As reported in the abstract
Clinical state transitions
Observational data: associations, not effects.
Further findings
Discharged alive
Secondary VF/pVT
- Secondary VF/pVT occurred
- 41.7%
Discharged alive
- Significantly higher in the ROSC group compared to the PEA and asystole groups
Predictors of achieving ROSC
- Being witnessed by bystanders or EMS and bystander CPR
- Adjusted logistic regression
Predictors of secondary VF/pVT
- Male gender, increased resuscitation duration and administering adrenaline prior to the first clinical state transition
- Transitioning into ROSC associated with reduced odds of secondary VF/pVT
- Transitioning into PEA increased the odds of secondary VF/pVT
- Adjusted logistic regression
Original publication
Clinical state transitions in shock-refractory ventricular fibrillation: an observational study. Resuscitation. Published 22 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it