Survival After XXXX Cardiac Arrest in the Sao Paulo Metropolitan Subway System: First Successful Targeted Automated External Defibrillator (AED) Program in Latin America.

@entity1 @entity16 @entity2224 @entity1167 @entity943
BACKGROUND: Targeted automated external defibrillator (AED) programs have improved survival rates among @entity1 who have an out-of-hospital @entity1167 (OHCA) in US airports, as well as European and Japanese railways. The Sao Paulo (Brazil) Metro subway carries 4.5 million @entity1 per day. A targeted AED program was begun in the Sao Paulo Metro with the objective to improve survival from @entity1167 . METHODS AND RESULTS: A prospective, longitudinal, observational study of all cardiac arrests in the Sao Paulo Metro was performed from September 2006 through November 2012. This study focused on @entity1167 by @entity943 , and the primary endpoint was survival to hospital discharge with minimal @entity16 . A total of 62 @entity1 had an initial cardiac rhythm of @entity2224 . Because no data on @entity1167 treatment or outcomes existed before beginning this project, the first 16 months of the implementation was used as the initial experience and compared with the subsequent 5 years of full operation. Return of spontaneous circulation was not different between the initial 16 months and the subsequent 5 years (6 of 8 [75%] vs. 39 of 54 [72%]; P=0.88). However, survival to discharge was significantly different once the full program was instituted (0 of 8 vs. 23 of 54 [43%]; P=0.001). CONCLUSIONS: Implementation of a targeted AED program in the Sao Paulo Metro subway system saved lives. A short interval between arrest and defibrillation was key for good long-term, neurologically intact survival. These results support strategic expansion of targeted AED programs in other large Latin American cities.
