Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry
Abstract Background Out-of-hospital cardiac arrest (OHCA) with shockable rhythms, including ventricular fibrillation and pulseless ventricular tachycardia, is associated with better prognosis and neurological outcome than OHCA due to other rhythms. Antiarrhythmic drugs, including lidocaine and amiod...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02920-2 |
| _version_ | 1811329127023640576 |
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| author | Yuki Kishihara Masahiro Kashiura Shunsuke Amagasa Fumihito Fukushima Hideto Yasuda Takashi Moriya |
| author_facet | Yuki Kishihara Masahiro Kashiura Shunsuke Amagasa Fumihito Fukushima Hideto Yasuda Takashi Moriya |
| author_sort | Yuki Kishihara |
| collection | DOAJ |
| description | Abstract Background Out-of-hospital cardiac arrest (OHCA) with shockable rhythms, including ventricular fibrillation and pulseless ventricular tachycardia, is associated with better prognosis and neurological outcome than OHCA due to other rhythms. Antiarrhythmic drugs, including lidocaine and amiodarone, are often used for defibrillation. This study aimed to compare the effects of lidocaine and amiodarone on the prognosis and neurological outcome of patients with OHCA due to shockable rhythms in a real-world setting. Methods We conducted a retrospective observational study using a multicenter OHCA registry of 91 participating hospitals in Japan. We included adult patients with shockable rhythms, such as ventricular fibrillation and pulseless ventricular tachycardia, who were administered either lidocaine or amiodarone. The primary outcome was 30-day survival, and the secondary outcome was a good neurological outcome at 30 days. We compared the effects of lidocaine and amiodarone for patients with OHCA due to shockable rhythms for these outcomes using logistic regression analysis after propensity score matching (PSM). Results Of the 51,199 patients registered in the OHCA registry, 1970 patients were analyzed. In total, 105 patients (5.3%) were administered lidocaine, and 1865 (94.7%) were administered amiodarone. After performing PSM with amiodarone used as the reference, the odds ratios and 95% confidence intervals of lidocaine use for 30-day survival and 30-day good neurological outcome were 1.44 (0.58–3.61) and 1.77 (0.59–5.29), respectively. Conclusion The use of lidocaine and amiodarone for patients with OHCA due to shockable rhythms within a real-world setting showed no significant differences in short-term mortality or neurological outcome. There is no evidence that either amiodarone or lidocaine is superior in treatment; thus, either or both drugs could be administered. |
| first_indexed | 2024-04-13T15:38:18Z |
| format | Article |
| id | doaj.art-0ad0065c83c54b1aabf9879802703d17 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-13T15:38:18Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-0ad0065c83c54b1aabf9879802703d172022-12-22T02:41:13ZengBMCBMC Cardiovascular Disorders1471-22612022-11-012211910.1186/s12872-022-02920-2Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registryYuki Kishihara0Masahiro Kashiura1Shunsuke Amagasa2Fumihito Fukushima3Hideto Yasuda4Takashi Moriya5Department of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical UniversityDepartment of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical UniversityDivision of Emergency and Transport Services, National Center for Child Health and DevelopmentDepartment of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical UniversityDepartment of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical UniversityDepartment of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical UniversityAbstract Background Out-of-hospital cardiac arrest (OHCA) with shockable rhythms, including ventricular fibrillation and pulseless ventricular tachycardia, is associated with better prognosis and neurological outcome than OHCA due to other rhythms. Antiarrhythmic drugs, including lidocaine and amiodarone, are often used for defibrillation. This study aimed to compare the effects of lidocaine and amiodarone on the prognosis and neurological outcome of patients with OHCA due to shockable rhythms in a real-world setting. Methods We conducted a retrospective observational study using a multicenter OHCA registry of 91 participating hospitals in Japan. We included adult patients with shockable rhythms, such as ventricular fibrillation and pulseless ventricular tachycardia, who were administered either lidocaine or amiodarone. The primary outcome was 30-day survival, and the secondary outcome was a good neurological outcome at 30 days. We compared the effects of lidocaine and amiodarone for patients with OHCA due to shockable rhythms for these outcomes using logistic regression analysis after propensity score matching (PSM). Results Of the 51,199 patients registered in the OHCA registry, 1970 patients were analyzed. In total, 105 patients (5.3%) were administered lidocaine, and 1865 (94.7%) were administered amiodarone. After performing PSM with amiodarone used as the reference, the odds ratios and 95% confidence intervals of lidocaine use for 30-day survival and 30-day good neurological outcome were 1.44 (0.58–3.61) and 1.77 (0.59–5.29), respectively. Conclusion The use of lidocaine and amiodarone for patients with OHCA due to shockable rhythms within a real-world setting showed no significant differences in short-term mortality or neurological outcome. There is no evidence that either amiodarone or lidocaine is superior in treatment; thus, either or both drugs could be administered.https://doi.org/10.1186/s12872-022-02920-2AmiodaroneLidocaineOut-of-hospital cardiac arrestShockable rhythm |
| spellingShingle | Yuki Kishihara Masahiro Kashiura Shunsuke Amagasa Fumihito Fukushima Hideto Yasuda Takashi Moriya Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry BMC Cardiovascular Disorders Amiodarone Lidocaine Out-of-hospital cardiac arrest Shockable rhythm |
| title | Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry |
| title_full | Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry |
| title_fullStr | Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry |
| title_full_unstemmed | Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry |
| title_short | Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry |
| title_sort | comparison of the effects of lidocaine and amiodarone for out of hospital cardiac arrest patients with shockable rhythms a retrospective observational study from a multicenter registry |
| topic | Amiodarone Lidocaine Out-of-hospital cardiac arrest Shockable rhythm |
| url | https://doi.org/10.1186/s12872-022-02920-2 |
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