Utilising a refractory ventricular fibrillation bundle to improve outcome in out of hospital cardiac arrest: A case report

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus Pub Date : 2025-08-14 DOI:10.1016/j.resplu.2025.101063

Isabel Horne , Thomas Gleeson-Hammerton , James Plumb , John Pike

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Abstract

Cardiac arrest secondary to persistent ventricular fibrillation or ventricular tachycardia (pVF/VT) is challenging to manage, particularly in the prehospital setting. This report, prepared in keeping with CARE guidelines, discusses a 70-year-old male who survived to discharge with pre-morbid neurological function after a prolonged cardiac arrest with pVF. Clinical interventions included mechanical CPR, vector change defibrillation, de-emphasised adrenaline and intravenous esmolol. We believe this may be the first reported case of a paramedic-led team providing this care bundle in the UK outside of a research setting.

In this case a refractory pVF/VT bundle appeared to be associated with terminating pVF. This report may be of use to other pre-hospital services considering introducing specialised care bundles for this case type, as well as adding to the body of evidence for the complex pharmacological relationship between adrenergic agonists, antagonists and persistent shockable rhythms.

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利用难治性心室颤动束改善院外心脏骤停的预后：一例报告

继发于持续性室性颤动或室性心动过速（pVF/VT）的心脏骤停是具有挑战性的管理，特别是在院前设置。本报告是根据CARE指南编写的，讨论了一位70岁的男性，他在长时间的心脏骤停与pVF后存活并出院，发病前神经功能正常。临床干预包括机械心肺复苏术，载体改变除颤，去肾上腺素和静脉注射艾司洛尔。我们认为，这可能是第一个报告的情况下，由护理人员领导的团队提供这种护理包在英国以外的研究设置。在这个病例中，难治性pVF/VT束似乎与pVF终止有关。本报告可用于其他院前服务，考虑为此类病例引入专门的护理包，并为肾上腺素能激动剂、拮抗剂和持续性休克节律之间复杂的药理学关系提供更多证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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