Key result
Electromechanical dissociation was associated with a 0% resuscitation success rate (0 of 36 episodes), compared to a 50% success rate for ventricular fibrillation (7 of 14 episodes).
Why the study?
Do metabolic or pharmacologic interventions reduce the incidence of electromechanical dissociation following cardiac arrest?
Observational (n=50)
Do metabolic or pharmacologic interventions reduce the incidence of electromechanical dissociation following cardiac arrest?
Absolute Event Rate: 0% vs 50%
Electromechanical dissociation is a highly lethal mechanism of cardiac arrest that was not prevented by glucose-insulin-potassium or methylprednisolone in an experimental model, though hypothermia delayed its onset.
Electromechanical dissociation signals near-certain resuscitation failure in monitored arrests; leaves open whether hypothermia or other interventions improve outcomes in prospective studies.
Electromechanical dissociation (EMD) is the most frequent cause of unsuccessful cardiac resuscitation in critically ill patients. In a clinical study of cardiac arrest, including 54 episodes in 50 fully monitored patients, 14 episodes of ventricular fibrillation were observed and seven were reversed. In the remaining 40 instances, 36 cases of EMD were initially observed. Four patients had asystole. None of the patients with EMD or asystole were successfully resuscitated. For objective study of EMD and its treatment, we developed an experimental model in which ventricular fibrillation was induced in mechanically ventilated dogs. EMD was predictably observed when, after an interval of 120 seconds, ventricular fibrillation was reversed with an external countershock. Neither metabolic acidosis nor metabolic alkalosis modified the incidence of EMD. A few dogs were pretreated with glucose-insulin-potassium or pharmacologic doses of methylprednisolone, but this did not clearly reduce the incidence of EMD. However, the onset of EMD was delayed when the body temperature of the animal was spontaneously reduced.
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Vincent et al. (1981) conducted an observational in Cardiac arrest (n=50). Electromechanical dissociation (EMD) vs. Ventricular fibrillation was evaluated on Successful cardiac resuscitation. Electromechanical dissociation was associated with a 0% resuscitation success rate (0 of 36 episodes), compared to a 50% success rate for ventricular fibrillation (7 of 14 episodes).
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