Ann Clin Anesth Res | Volume 1, Issue 1 | Research Article | Open Access

Termination of Ventricular Fibrillation and Pulseless Ventricular Tachycardia Using the Precordial Thump

Athanasios Chalkias^1,2*, Anastasios Koutsovasilis³, Athanasios Gravos⁴, Konstantinos Sakellaridis⁴, Alexandra Avraamidou⁴, Katerina Nodarou⁴, Thomas Nitsotolis⁴, Spyros Vaggelis⁴, Georgios Tzanoudakis⁴, Konstantina Katsifa⁴, Barbara Grammatikopoulou⁴, Drosos Venetoulis⁴, Martha Kelesi⁵, Athanasios Prekates⁴, Paraskevi Tselioti⁴, Eugenia Vlachou⁵ and Theodoros Xanthos^2,6

¹University of Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
²Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece
³Department of Internal Medicine, Nikaia General Hospital, Piraeus, Greece
⁴Intensive Care Unit, Tzaneio General Hospital of Piraeus, Piraeus, Greece
⁵Technological Educational Institute of Athens, Athens, Greece
⁶European University Cyprus, School of Medicine, Nicosia, Cyprus

^*Correspondance to: Athanasios Chalkias 

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Abstract

Background: Although the effectiveness of precordial thump is controversial, it remains a common strategy during cardiopulmonary resuscitation. We investigated the effectiveness of precordial thump in the treatment of monitored ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest.Methods: A total of 922 patients were categorized according to their first-line treatment into the defibrillation group and the precordial thump group. In the defibrillation group, we included all monitored victims who were immediately defibrillated after cardiac arrest was recognized and underwent subsequent cardiopulmonary resuscitation, while in the precordial thump group, the victims received immediately at least one precordial thump followed by immediate cardiopulmonary resuscitation.Results: Two hundred and nine (42.4%) defibrillation group and 10 (2.3%) precordial thump group victims restored spontaneous circulation after the first shock and first precordial thump, respectively (p=0.008). The proportion of victims achieving spontaneous circulation at any time during cardiopulmonary resuscitation was higher in the defibrillation group compared to the precordial thump group, while time to first shock was higher in the precordial thump group (p=0.038). Victims in the precordial thump group were associated with a higher proportion of suffering a re-arrest during the immediate and early post-arrest phases compared to those in the defibrillation group (p=0.035).Conclusion: The precordial thump was ineffective in terminating most of ventricular fibrillation/ pulseless ventricular tachycardia.

Keywords:

Cardiac arrest; Ventricular fibrillation; Pulseless ventricular tachycardia; Precordial thump; Return of spontaneous circulation

Citation:

Chalkias A, Koutsovasilis A, Gravos A, Sakellaridis K, Avraamidou A, Nodarou K, et al. Termination of Ventricular Fibrillation and Pulseless Ventricular Tachycardia Using the Precordial Thump. Ann Clin Anesth Res. 2017;1(1): 1001.