Out-of-hospital Cardiac Arrest Treated with Prehospital Double Sequential External Defibrillation During ECPR in Refractory VF - a Case Report

Overview

Journal Int J Emerg Med

Publisher Biomed Central

Specialty Emergency Medicine

Date 2023 Oct 12

PMID 37828482

Authors

Stephan Katzenschlager

Raphael Heck

Erik Popp

Frank Weilbacher

Markus A Weigand

Christoph Eisner

Christopher Neuhaus

Affiliations

Soon will be listed here.

Abstract

Background: Double sequential external defibrillation (DSED) has demonstrated increased survival with good neurological outcome in a recent randomized controlled trial. DSED has not been studied in patients with extracorporeal cardiopulmonary resuscitation (eCPR).

Case: We present the first case of prehospital eCPR with ongoing refractory ventricular fibrillation (VF), terminated by DSED. After six shocks, return of spontaneous circulation was initially achieved; however, the patient went into recurrent VF. ECPR was performed prehospital, with VF still refractory after three more shocks. DSED successfully terminated VF and showed a further increase in etCO and near-infrared spectroscopy cerebral oximetry values.

Conclusion: DSED can be a sufficient strategy for patients in refractory VF while on eCPR and should be evaluated in further studies.

Citing Articles

Assess, improve, detect, guide: a narrative review and proposal for a standardized protocol for prehospital transesophageal echocardiography during out-of-hospital cardiac arrest.

Katzenschlager S, Hamp T, Dietrich M, Edmunds C, Kaltschmidt N, Weigand M Ultrasound J. 2025; 17(1):18.

PMID: 40042695 PMC: 11883077. DOI: 10.1186/s13089-025-00418-4.

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