Resuscitation
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Multicenter Study Clinical Trial
Chest compression quality variables influencing the temporal development of ROSC-predictors calculated from the ECG during VF.
Predictive measures that reflect the probability of return of spontaneous circulation (ROSC) if the patient is defibrillated can be calculated from the electrocardiogram during ventricular fibrillation (VF) and ventricular tachycardia (VT). It has not been studied how the quality of chest compressions affect the development of such ROSC predictors. ⋯ Using MS as an indicator of the state of the myocardium, force-based compression quality variables are better indicators of efficient CPR than compression depth. A novel indicator termed residual heart force gives the best correlation with observed trends in MS.
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Randomized Controlled Trial
Predictive power of serum NSE and OHCA score regarding 6-month neurologic outcome after out-of-hospital ventricular fibrillation and therapeutic hypothermia.
To determine the predictive power of the out-of-hospital cardiac arrest (OHCA) score and serum neuron-specific enolase (NSE) in patients resuscitated from ventricular fibrillation treated with therapeutic hypothermia (TH) and glucose control. ⋯ Increase in NSE between 24 and 48h and NSE at 48h is specific but only moderately sensitive markers of 6-month outcome. Outcome prediction at ICU admission using the OHCA score was not possible in this selected patient population.
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Patients who survive after suicidal hanging attempts suffer from transient brain ischaemia. Morbidity and mortality is high, and no specific therapy is available. Hypothermia attenuates ischaemic brain damage and has become standard care in comatose survivors of cardiac arrest; therapeutic hypothermia may thus be useful for near-hanging victims as well. ⋯ No randomised, controlled trial for treatment of near-hanging victims has been published. No conclusions could be drawn regarding treatment effects of hypothermia in this survey, but in the absence of better evidence, it seems reasonable to consider hypothermia treatment in all comatose near-hanging victims.