JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study
Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial.
A strategy using mechanical chest compressions might improve the poor outcome in out-of-hospital cardiac arrest, but such a strategy has not been tested in large clinical trials. ⋯ Among adults with out-of-hospital cardiac arrest, there was no significant difference in 4-hour survival between patients treated with the mechanical CPR algorithm or those treated with guideline-adherent manual CPR. The vast majority of survivors in both groups had good neurological outcomes by 6 months. In clinical practice, mechanical CPR using the presented algorithm did not result in improved effectiveness compared with manual CPR.
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Randomized Controlled Trial
Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest: a randomized clinical trial.
Hospital cooling improves outcome after cardiac arrest, but prehospital cooling immediately after return of spontaneous circulation may result in better outcomes. ⋯ Although use of prehospital cooling reduced core temperature by hospital arrival and reduced the time to reach a temperature of 34°C, it did not improve survival or neurological status among patients resuscitated from prehospital VF or those without VF.
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Are glucocorticoids, alone or combined with bronchodilators, associated with reduced admission rates, length of stay, or improvements in clinical severity scores without increased adverse effects in infants and young children with acute viral bronchiolitis? ⋯ There is no consistent clinically relevant association of single therapy with systemic or inhaled glucocorticoids and improved outcomes in either outpatient or inpatient settings. Exploratory evidence suggests that combined glucocorticoids and nebulized epinephrine may be associated with lower hospitalization rates in outpatients, but these findings must be interpreted cautiously.