Observational studyResuscitation2025
The association between initial defibrillation dose and outcomes following adult out-of-hospital cardiac arrest resuscitation: A retrospective, multi-agency study.
Observational study in Resuscitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Energy doses for paediatric defibrillation in cardiac arrest: systematic review and meta-analysis.Resuscitation plus · 2025Review
- Considerations on witnessed status, bystander CPR, and statistical methods in OHCA defibrillation dose-outcome study.Resuscitation plus · 2025Article
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8 authors.
Funding
Abstract
introductionEffective defibrillation is essential to out-of-hospital cardiac arrest (OHCA) survival. International guidelines recommend initial defibrillation energies between 120 and 360 Joules, which has led to widespread practice variation. Leveraging this natural experiment, we aimed to explore the association between initial defibrillation dose and outcome following OHCA.
methodsThe ESO Data Collaborative (2018-2022) was used for this nationwide, retrospective study of adult (18-80 years of age) non-traumatic OHCA patients who presented with an initially shockable ECG rhythm. We excluded patients if they had ROSC prior to initial defibrillation, a resuscitation-limiting advanced directive, or were residents in a healthcare institution. The primary exposure was initial defibrillation dose, defined as Joules per kilogram of body weight, and the primary outcome was return of spontaneous circulation (ROSC). We included survival to discharge as a secondary outcome. We used multivariable logistic regression modeling to assess the relationship between defibrillation dose and outcome.
resultsWe analyzed data from 21,121 patients. Of the 12,160 patients linked to a defibrillator manufacturer, 7,240 (59.5%) were treated using a biphasic truncated exponential (BTE) waveform and 4,920 (40.5%) were treated using a rectilinear biphasic (RLB) waveform. Defibrillation dose (per 1 J/kg increase) was not associated with ROSC (BTE aOR: 0.97 [0.92, 1.01], n = 7,240; RLB aOR: 1.00 [0.92, 1.09], n = 4,920; all aOR: 1.01 [0.98, 1.04], 21,121) or survival (BTE aOR: 0.98 [0.87, 1.10], n = 1,245; RLB aOR: 0.89 [0.70, 1.12], n = 775; all aOR: 1.00 [0.92, 1.08], n = 2,981).
conclusionsInitial defibrillation dose was not associated with outcome in this nationwide cohort.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.