Resuscitation
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Multicenter Study Observational Study
Regional cerebral oxygen saturation monitoring for predicting interventional outcomes in patients following out-of-hospital cardiac arrest of presumed cardiac cause: A prospective, observational, multicentre study.
This study investigated the value of regional cerebral oxygen saturation (rSO2) monitoring upon arrival at the hospital for predicting post-cardiac arrest intervention outcomes. ⋯ rSO2 is a good indicator of 90-day neurologic outcomes for post-cardiac arrest intervention patients.
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Randomized Controlled Trial
The effect of targeted temperature management on coagulation parameters and bleeding events after out-of-hospital cardiac arrest of presumed cardiac cause.
Targeted temperature management (TTM) is part of the standard treatment of comatose patients after out-of-hospital cardiac arrest (OHCA) to attenuate neurological injury. In other clinical settings, hypothermia promotes coagulopathy leading to an increase in bleeding and thrombosis tendency. Thus, concern has been raised as to whether TTM can be applied safely, as acute myocardial infarction requiring primary percutaneous coronary intervention (PCI) with the need of effective antiplatelet therapy is frequent following OHCA. This study investigated the influence of TTM at 33 or 36°C on various laboratory and coagulation parameters. ⋯ There was no evidence supporting the assumption that TTM at 33°C was associated with impaired hemostasis or increased the frequency of adverse bleeding and thrombotic events compared to TTM at 36°C. We found that TTM at either temperature can safely be applied in the postresuscitation phase after acute myocardial infarction and primary PCI.
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A preceding randomized controlled trial demonstrated that chest compression-only cardiopulmonary resuscitation (CPR) instruction by dispatcher was more effective to increase bystander CPR than conventional CPR instruction. However, the actual condition of implementation of each type of dispatcher instruction (chest compression-only CPR [CCCPR] or conventional CPR with rescue breathing) and provision of bystander CPR in real prehospital settings has not been sufficiently investigated. ⋯ CCCPR dispatcher instruction among adult OHCA patients significantly increased the actual provision of bystander CPR.
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Biography Historical Article
Ian Jacobs - Resuscitation leader, educator and researcher.
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Randomized Controlled Trial
Two minutes CPR versus five cycles CPR prior to reanalysis of the cardiac rhythm: A prospective, randomized simulator-based trial.
While the 2005 cardiopulmonary resuscitation (CPR) guidelines recommended to provide CPR for five cycles before the next cardiac rhythm check, the current 2010 guideline now recommend to provide CPR for 2 min. Our aim was to compare adherence to both targets in a simulator-based randomized trial. ⋯ This randomized simulator-based trial found better adherence and less variance to an instruction to continue CPR for five cycles before the next cardiac rhythm check compared to continuing CPR for 2 min. Avoiding temporal targets whenever possible in guidelines relating to stressful events appears advisable.