Prehospital transcutaneous cardiac pacing for symptomatic bradycardia or bradyasystolic cardiac arrest: A systematic review
作者： Jonathan Sherbino , P. Richard Verbeek , Russell D. MacDonald , Bruce V. Sawadsky , Andrew C. McDonald
DOI: 10.1016/J.RESUSCITATION.2005.11.019
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摘要: Summary Background Advanced cardiac life support (ACLS) guidelines suggest transcutaneous pacing (TCP) for the treatment of symptomatic bradycardia (SB) and bradyasystolic arrest (BACA). Many EMS systems are extrapolating these employing TCP in prehospital setting. Our objective was to conduct a systematic review determine efficacy management two conditions. Methods MEDLINE (1966–2004), EMBase Science Citation Index (1980–2004) were searched using: / emergency medical services ; external . Two reviewer teams blinded source author conducted hierarchical selection (title, abstract, article) quality assessment using validated scale. Kappa agreement at each level measured. Data abstraction done by consensus. Results Thirty-four articles identified seven selected (Kappa agreement; title: 0.85, abstract: 0.78, full article: 0.82). Article poor all trials. There three case series (BACA, n =215), unblinded randomised controlled trials (one BACA, BACA+SB), one subgroup analysis. In paced BACA patients, 0/215 survived hospital discharge. 16/509 (paced) versus14/497 (control) SB trial 5/6 versus 1/7 discharge ( p =0.01). When combined with 4/27 0/24 =0.07). Conclusions setting, there is no evidence use arrest. inadequate bradycardia.
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