Resuscitation
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Observational Study
The Duration of Cardiopulmonary Resuscitation in Emergency Departments after Out-of-Hospital Cardiac Arrest is Associated with the Outcome: A Nationwide Observational Study.
The appropriate duration of cardiopulmonary resuscitation (CPR) for patients who experience out-of-hospital cardiac arrest (OHCA) remains unknown. This study aimed to evaluate the duration of CPR in emergency departments (EDs) and to determine whether the institutions' median duration of CPR was associated with survival-to-discharge rate. ⋯ The duration of CPR varied widely among hospitals. The institutional duration of CPR less than 20 min was significantly associated with lower survival-to-discharge rate.
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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
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.
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Randomized Controlled Trial Multicenter Study
Impact of time to return of spontaneous circulation on neuroprotective effect of targeted temperature management at 33 or 36 degrees in comatose survivors of out-of hospital cardiac arrest.
Time to Return of Spontaneous Circulation (ROSC) has a plausible relation to severity of hypoxic injury before and during resuscitation in Out-of-Hospital Cardiac Arrest (OHCA), and has consistently been associated with adverse outcome. The effect of Targeted Temperature Management (TTM) may not be similar over the full spectrum of time to ROSC. This study investigated the possible beneficial effect of targeting 33°C over 36°C on the prognostic importance of time to ROSC. ⋯ Time to ROSC remains a significant prognostic factor in comatose OHCA patients with regards to risk of death and risk of adverse neurological outcome. For any time to ROSC, targeting 33°C in TTM was not associated with benefit with regards to reducing mortality or risk of adverse neurological outcome compared to targeting 36°C.
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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.