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. 2025 Jan 16:22:100873.
doi: 10.1016/j.resplu.2025.100873. eCollection 2025 Mar.

Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrest

Emma Menant  1 , Delphine Lavignasse  1 , Sarah Ménétré  2 , Jean-Philippe Didon  2 , Xavier Jouven  1
Affiliations

Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrest

Emma Menant et al. Resusc Plus. .

Abstract

Objective: This study aims to quantify the reliability of automated external defibrillators (AED) in paediatric out-of-hospital cardiac arrests (pOHCA) by evaluating the defibrillation and the shock advisory system efficacy. Furthermore, the relationship between the initial energy dose and patient outcomes is analysed.

Methods: We studied data from all pOHCA cases (age < 18 years) treated by the Paris Fire Brigade between January 2010 and December 2018, limited to those with available AED signals. The efficacy of shocks is the primary outcome. The secondary outcomes are the shock advisory system performance, pre-hospital return of a spontaneous circulation (ROSC), survival and energy dose. Energy dose, weight and age are compared using a Wilcoxon test according to the outcome's values.

Results: A total of 1,990 electrocardiogram strips extracted from 349 pOHCA cases were included in the study. Shock advisory system had a sensitivity of 89.4% and a specificity of 99.8% for the detection of shockable rhythms. Shock efficacy observed for all patients who received a shock was 83.1% and first shock efficacy for patients in initial ventricular fibrillation was 96%. Patients who received a shock had a pre-hospital ROSC rate of 74.3%, a survival rate at hospital admission of 71.4% and 34.3% at hospital discharge.

Conclusion: This study shows that AED detect shockable rhythm with a good sensitivity and specificity and that shocks are associated with a very high rates of termination of shockable rhythms in pOHCA.

Keywords: Automated external defibrillator; Energy dose; Paediatric out-of-hospital cardiac arrest; Shock advisory system; Shock efficacy; Survival.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Emma Menant reports a relationship with SCHILLER Médical, Wissembourg, France that includes: receiving research support. Delphine Lavignasse reports a relationship with SCHILLER Médical, Wissembourg, France that includes: receiving research support. Sarah Ménétré reports a relationship with SCHILLER Médical, Wissembourg, France that includes: employment. Jean-Philippe Didon reports a relationship with SCHILLER Médical, Wissembourg, France that includes: employment. Xavier Jouven reports a relationship with SCHILLER Médical, Wissembourg, France that includes: receiving funds for scientific consulting. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flow chart of pOHCA shock and rhythm analysis (with n the number of strips and N the number of patients). OHCA: Out-of-hospital cardiac arrest; AED: Automated External Defibrillator; ECG: Electrocardiogram; CC: Chest Compressions; VF: Ventricular Fibrillation; VT: Ventricular Tachycardia; iVF: initial VF.
Fig. 2
Fig. 2
Rhythm in the first two minutes after the first shock of iVF patients. Rhythm annotations were done at 5, 15, 30, 60 and 120 s after the first shock. Annotations before 5 s was not possible because of shock artifacts and unstable electrocardiographic baseline. Indeterminate: unreadable post-shock rhythm due to presence of chest compressions.
See this image and copyright information in PMC

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