Ultraportable Defibrillator !!! Can be it be game changer ?

Defibrillation as option for treatment for cardiac arrest was first described by Zoll et (N Eng J Med. 1952). Zoll et al in his articles mentions that "The purpose of this report is to describe the successful use in 2 patients of a quick, simple, effective and safe method of arousing the heart from ventricular standstill by an artificial, external, electric pacemaker. For the first time it was possible to keep a patient alive during ventricular asystole lasting for hours to days. This procedure may prove valuable in many clinical situations".

Over the years the defibrillators have been evolved from monophasic to biphasic, High energy to low energy defibrillators. Recently a new genration of defibrillators called ultra portable defibrillators have been launched.

 

Ultraportable automated external defibrillators (AEDs) are a new generation of defibrillators that are small, lightweight, easy to carry on one’s person, and affordable for personal and home use. They offer the opportunity to increase AED availability in case of out-of-hospital cardiac arrest (OHCA) and therefore improve outcomes.

Debaty et al did a systemic review on effectiveness of ultra portable automated external defibrillator found no evidence of ultraportable AED device performance, clinical or safety outcomes. There is an urgent need for further research to determine the safety and effectiveness of ultraportable AEDs.

Concerns

• Limitations number of shocks : 20
• Energy: Max 75 J (Manufactures claim its not the energy , its current which is important and they have engineered the device to deliver the same current with lesser energy.)

Guidelines

• ILCOR 2024 states that currently there is insufficient evidence on the clinical effectiveness of ultraportable or pocket AEDs to make a treatment recommendation. 

Conclusion 

• As of now there is no evidence or recommendation for the use of ultraportable defibrillators. Ultraportable Defibrillators are evolving and as more evidences arises they can be a game changer in management  out of hospital cardiac arrest. 

Reference

• Debaty G, Perkins GD, Dainty KN, Norii T, Olasveengen TM, Bray JE; International Liaison Committee on Resuscitation Basic Life Support Task Force. Effectiveness of ultraportable automated external defibrillators: A scoping review. Resusc Plus. 2024 Aug 7;19:100739. doi: 10.1016/j.resplu.2024.100739. PMID: 39219811; PMCID: PMC11362796.

• S.C. Brooks, G.R. Clegg, J. Bray, et al. Optimizing outcomes after out-of-hospital cardiac arrest with innovative approaches to public-access defibrillation: A scientific statement from the international liaison committee on resuscitation Resuscitation, 172 (2022), pp. 204-228