While studies have shown that AEDs have a positive impact on survival for patients who experience out-of-hospital cardiac arrest, possibly due to the associated rhythm disturbances that are often treatable with defibrillation, the same results are not seen in patients with in-hospital cardiac arrest.

 

The study authors used data from the National Registry of Cardiopulmonary Resuscitation (NRCPR) to evaluate the association between survival after in-hospital cardiac arrest and the use of an AED. In their study, published in Australian Critical Care (24(3)210-212, 2011) , the authors examined data drawn from 11,695 patients (from 204 hospitals), aged 18  years or older, who had an index pulseless, in-hospital cardiac arrest in a clinical  area where an AED was available for patient treatment.

 

The study authors reported that the rate of nonshockable rhythms was significantly higher than the rate of shockable rhythms. Further, they claim, the high incidence of initial nonshockable rhythm was also much higher than reported in other studies.

 

According to the study authors, "Overall, the use of the AEDs on general wards did not increase survival for patients who experienced ventricular fibrillation or pulseless ventricular tachycardia cardiac arrests when compared to the group where a standard defibrillator was used."

 

Furthermore, this conclusion reflects the results of other studies that also observed "no survival-to-discharge benefit in the in-hospital setting following the introduction of AEDs."

 

Consequently, the authors question the routine introduction of in-hospital use of and reliance on AEDs. They also emphasised that hospitals should be made aware of the potential adverse impact of AEDs on patient survival and the importance of early, effective and uninterrupted chest compressions.