Out of hospital cardiac arrest treated with prehospital double sequential external defibrillation during eCPR in refractory VF – a case report

Abstract

Abstract Double sequential external defibrillation (DSED) has demonstrated increased survival with good neurological outcome in a recent randomized controlled trial. DSED has not been studied in patients with extracorporeal cardiopulmonary resuscitation (eCPR). We present the first case of prehospital eCPR with ongoing refractory ventricular fibrillation (VF), terminated by DSED. After six shocks return of spontaneous circulation was initially achieved, however the patient went into recurrent VF. ECPR was performed prehospitally, with VF still refractory after three shocks. DSED successfully terminated VF and showed a further increase in etCO2 and near-infrared spectroscopy cerebral oximetry values.