Resuscitation
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Multicenter Study
The association of body mass index with time to target temperature and outcomes following post-arrest targeted temperature management.
Evidence suggests that more rapid attainment of target temperature (32-34°C) improves neurologic outcome following cardiac arrest and targeted temperature management (TTM). It is unclear to what extent body mass index (BMI) is associated with the time to reach target temperature and subsequent clinical outcomes. ⋯ Target temperature was frequently achieved within 4-6h; as BMI increased, the time to reach target temperature from initiation of TTM was prolonged. There was no significant difference across BMI groups for survival or good neurologic outcome.
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Multicenter Study Observational Study
Health-related quality of life improves during the first six months after cardiac arrest and hypothermia treatment.
To investigate whether there were any changes in and correlations between anxiety, depression and health-related quality of life (HRQoL) over time, between hospital discharge and one and six months after cardiac arrest (CA), in patients treated with therapeutic hypothermia (TH). ⋯ HRQoL improves over the first 6 months after a CA. Patients reported lower levels of HRQoL on the physical as compared to mental component. The results indicate that the less anxiety and depression patients perceive, the better HRQoL they have and that time can be an important factor in recovery after CA.
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Multicenter Study
The impact of an intervention package promoting effective neonatal resuscitation training in rural China.
To evaluate an intervention package promoting effective neonatal resuscitation training at county level hospitals across China. ⋯ The intervention has not only improved skills of health providers, decreased the mortality and morbidity of birth asphyxia, but also resulted in effective implementation of guidelines and protocols within hospitals.
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Multicenter Study
Prognostic value of cell-free DNA in plasma of out-of-hospital cardiac arrest survivors at ICU admission and 24hours post-admission.
Cell-free DNA has been associated with outcome in several acute conditions including two reports concerning the outcomes after cardiac arrest that found association of circulating DNA quantities at admission with mortality. The origins of cell-free DNA are primarily necrosis and apoptosis, which in cardiac arrest occur during ischaemia ("no-flow" and "low-flow" period), during reperfusion injury and as a consequence of post-arrest inflammatory response. Respecting the facts that significant cellular damage may occur during the post-arrest period, and that damage might be reduced by mild therapeutic hypothermia, we investigated the prognostic value of cell free DNA at ICU admission and 24h after admission. ⋯ Cell free DNA showed different dynamics in patients who were and who were not treated with mild therapeutic hypothermia: it decreased in treated patients and slightly increased in non-treated patients. Cell-free DNA quantity at ICU admission and 24h after admission is associated with hospital mortality. Further studies will need to additionally investigate possible practical use of this new laboratory marker in patients resuscitated from cardiac arrest.
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Multicenter Study
Association between resuscitation time interval at the scene and neurological outcome after out-of-hospital cardiac arrest in two Asian cities.
It is unclear whether the scene time interval (STI) for cardiopulmonary resuscitation (CPR) is associated with outcomes of out-of-hospital cardiac arrest (OHCA) or not. The present study aimed to determine the association between STI and neurological outcome after OHCA using two large population-based cohorts covering two metropolitan cities in Asia. ⋯ Data from two metropolitan cities demonstrated a positive association between intermediate STI from 8 to 16min and good neurological outcome after OHCA.