Resuscitation
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Randomized Controlled Trial Multicenter Study
The relationship between shocks and survival in out-of-hospital cardiac arrest patients initially found in PEA or asystole.
To describe survival rates from out-of-hospital cardiac arrest for patients who present with pulseless electrical activity or asystole according to whether they remained in a non-shockable rhythm or converted to ventricular fibrillation and were shocked appropriately. ⋯ These results suggest that patients with cardiac arrest who develop VF during the course of treatment for initially observed pulseless electrical activity or asystole do not benefit from conventional approaches to treatment such as defibrillation. Further study is warranted to define the optimal treatment of this patient cohort.
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CPR quality is an important determinant of cardiac arrest outcome. Recent investigations have demonstrated that quality of clinical CPR is variable and often not in compliance with international consensus guidelines. The 2005 update of these guidelines included new recommendations for the measurement of resuscitation and CPR performance and the institution of measures to improve resuscitation care. Common definitions and reporting templates need to be established for the variables of CPR quality. This will allow for meaningful comparisons between treatment groups in clinical trials as well as a common system for quality improvement and documentation of this improvement. ⋯ In this report, we present the results from an international consensus working group to propose common definitions and criteria for reporting variables of CPR quality, based on the best available data for the importance of various CPR variables. The recommendations are discussed in light of the different purposes outlined above.
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Studies have suggested that emesis may occur in up to a third of cardiac arrest patients. The goal of this investigation was to characterize the frequency, timing, and outcome association of emesis in persons suffering out-of-hospital cardiac arrest in order to understand the role and care-implications of emesis better. ⋯ Given the frequency of emesis, the potential that some portion of emesis may be related to care, and the adverse association between emesis and survival, approaches that treat or prevent emesis better may improve the chances of survival following out-of-hospital cardiac arrest.
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To investigate whether transoesophageal cardiac pacing can induce ventricular fibrillation (VF) and how long the cardiac pacing has to be sustained to prevent the reversion of the VF induced. ⋯ Transoesophageal cardiac pacing can induce VF in rats. However, the cardiac pacing is required for at least 120-180 s to ensure that VF does not spontaneously convert. We can use the technique to establish a new and simpler rat cardiac arrest (CA) model, which may facilitate experimental investigation on CPR.