Resuscitation
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To investigate the therapeutic impact of combining extracorporeal membrane oxygenation (ECMO) and early coronary revascularization on acute myocardial infarction (AMI)-induced cardiopulmonary collapse. ⋯ Early revascularization on ECMO is practical to preserve myocardial viability and bridge patients collapsing with AMI to recovery.
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Early administration of epinephrine (Epi) improves outcomes in animal models of cardiac arrest, but there is limited time-dependent clinical data regarding its benefit. ⋯ Within the limitations of our study, this data suggests improved rates of ROSC with early Epi administration during OHCA resuscitation, but this study lacks adequate sample size to demonstrate impact on survival to discharge. Large prospective trials are needed to further delineate the benefit of early Epi administration in OHCA.
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Observational Study
Exploring gender differences and the "oestrogen effect" in an Australian out-of-hospital cardiac arrest population.
Recent studies have suggested gender differences in out-of-hospital cardiac arrests (OHCA) including outcomes favouring young women. We aimed to investigate these findings in an Australian OHCA population using the Victorian Ambulance Cardiac Arrest Registry (VACAR). ⋯ Women were more likely to survive to hospital arrival despite less favourable baseline variables. However, this initial improvement in survival did not translate to better survival to hospital discharge either overall, or in women of a reproductive age. Further study is required to determine gender differences in the underlying causes of OHCA and in EMS transportation practices.
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Observational Study
aEEG and NIRS during transition and resuscitation after birth: promising additional tools; an observational study.
During resuscitation no routine cerebral monitoring is available. We aimed at monitoring cerebral activity and oxygenation continuously during neonatal transition and resuscitation. ⋯ This is the first study demonstrating that monitoring of aEEG and NIRS to measure cerebral activity and oxygenation during immediate postpartum transition is feasible. During transition compromised neonates requiring resuscitation showed a different cerebral activity pattern compared to uncompromised neonates.
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Since the introduction of telemetry over a half century ago, it has expanded to various units and wards within health care institutions outside of the traditional critical care setting. Little is known on whether routine telemetry use is beneficial in this patient population. The aim of this study was to determine the impact of telemetry monitoring on survival of in-hospital cardiac arrests in patients admitted to non-critical care units. ⋯ Regardless of whether cardiac arrest was witnessed or unwitnessed, telemetry use was an independent and strong predictor of survival to hospital discharge.