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What is the optimal paddle force for defibrillation? (presented at 18th Spring Meeting of the Association of Cardiothoracic Anaesthetists: Selected abstracts Cambridge, UK. 22 June 2001)

What is the optimal paddle force for defibrillation? (presented at 18th Spring Meeting of the Association of Cardiothoracic Anaesthetists: Selected abstracts Cambridge, UK. 22 June 2001)
What is the optimal paddle force for defibrillation? (presented at 18th Spring Meeting of the Association of Cardiothoracic Anaesthetists: Selected abstracts Cambridge, UK. 22 June 2001)
Introduction - Firm paddle pressure during defibrillation is important to minimize transthoracic impedance (TTI) and optimize trans-myocardial current. Previous European Resuscitation Council (ERC) guidelines recommended that 12 kg force should be used [1] and the more recent International Liaison Committee on Resuscitation (ILCOR) guidelines recommend 'firm' pressure [2]. The actual relationship between force and transthoracic impedance has not been established. Methods - 55 patients (36 male, 19 female) undergoing general anaesthesia for cardiac surgery were investigated. Male chests were shaved. A pair of gel pads and paddles were placed in the anterior-apical position according to the ILCOR guidelines. The endotracheal tube was opened to air and paddles instrumented with force sensors were applied to the chest wall with progressive force to a maximum of 12 kgf. The resultant TTI was recorded at 10 measurements per second to a hard drive.
Results - Light pressure results in a high TTI that rapidly decreases as paddle force increases (Fig. 1). An 18.7% fall in overall TTI occurs when applying force from 0.5 to 6.0 kg. Increasing paddle force from 6 to 12 kg results in a further decrease in TTI of 3.2%.
Conclusion - A minimum of 6 kg force applied to each paddle is necessary to achieve 83% of the overall decrease in TTI seen at 12 kgf. Further decrease in TTI as force is applied in excess of 6 kgf is small and a force of 12 kgf only reduces TTI by a further 3.2% compared with TTI at 6 kgf. The additional clinical benefit of applying 12 kgf as opposed to 6 kgf is questionable.
1364-8535
Deakin, C.D.
83906241-b698-496f-9853-41333a19ac1d
Sado, D.M.
0ba2017a-85b2-46d1-b0d8-1e54bfddf827
Petley, G.W.
66beacdf-9753-4309-8483-d6107c34cf29
Clewlow, F.
06b8840f-4ccd-48cc-9a1e-d89f4960960d
Deakin, C.D.
83906241-b698-496f-9853-41333a19ac1d
Sado, D.M.
0ba2017a-85b2-46d1-b0d8-1e54bfddf827
Petley, G.W.
66beacdf-9753-4309-8483-d6107c34cf29
Clewlow, F.
06b8840f-4ccd-48cc-9a1e-d89f4960960d

Deakin, C.D., Sado, D.M., Petley, G.W. and Clewlow, F. (2001) What is the optimal paddle force for defibrillation? (presented at 18th Spring Meeting of the Association of Cardiothoracic Anaesthetists: Selected abstracts Cambridge, UK. 22 June 2001). Critical Care, 5 ((Suppl C):4). (doi:10.1186/cc1033).

Record type: Article

Abstract

Introduction - Firm paddle pressure during defibrillation is important to minimize transthoracic impedance (TTI) and optimize trans-myocardial current. Previous European Resuscitation Council (ERC) guidelines recommended that 12 kg force should be used [1] and the more recent International Liaison Committee on Resuscitation (ILCOR) guidelines recommend 'firm' pressure [2]. The actual relationship between force and transthoracic impedance has not been established. Methods - 55 patients (36 male, 19 female) undergoing general anaesthesia for cardiac surgery were investigated. Male chests were shaved. A pair of gel pads and paddles were placed in the anterior-apical position according to the ILCOR guidelines. The endotracheal tube was opened to air and paddles instrumented with force sensors were applied to the chest wall with progressive force to a maximum of 12 kgf. The resultant TTI was recorded at 10 measurements per second to a hard drive.
Results - Light pressure results in a high TTI that rapidly decreases as paddle force increases (Fig. 1). An 18.7% fall in overall TTI occurs when applying force from 0.5 to 6.0 kg. Increasing paddle force from 6 to 12 kg results in a further decrease in TTI of 3.2%.
Conclusion - A minimum of 6 kg force applied to each paddle is necessary to achieve 83% of the overall decrease in TTI seen at 12 kgf. Further decrease in TTI as force is applied in excess of 6 kgf is small and a force of 12 kgf only reduces TTI by a further 3.2% compared with TTI at 6 kgf. The additional clinical benefit of applying 12 kgf as opposed to 6 kgf is questionable.

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Published date: 2001

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Local EPrints ID: 8996
URI: https://eprints.soton.ac.uk/id/eprint/8996
ISSN: 1364-8535
PURE UUID: aaa4d3ca-1a13-43c8-a7bb-3e333fa73d49

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Date deposited: 14 Sep 2004
Last modified: 17 Jul 2017 17:12

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