Resuscitation
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Multicenter Study
Out-of-Hospital Cardiac Arrests in Children and Adolescents: Incidences, Outcomes, and Household Socioeconomic Status.
There is insufficient knowledge of out-of-hospital cardiac arrest (OHCA) in the very young. ⋯ OHCA incidences and survival rates varied significantly between age groups. High parental education was found to be associated with improved survival after OHCA.
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The rhythm analysis algorithm (RAA) of automated external defibrillators (AEDs) may be deceived by many factors. In this observational study we assessed RAA accuracy in prehospital interventions. For every rhythm analysis judged to be inaccurate, we looked for causal factors and estimated the impact on outcome. ⋯ Up to 16% of shockable rhythms were not detected and 4% of non-shockable rhythms were interpreted as shockable. Therefore, all AED interventions should be reviewed. Feedback to caregivers may avoid future deleterious interactions with the AED, whereas AED manufacturers may use this information to improve RAA accuracy. This approach may improve the outcome of some VF patients.
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To determine the accuracy and reliability of the thoracic impedance (TI) signal to assess cardiopulmonary resuscitation (CPR) quality metrics. ⋯ With our data, the TI can be reliably used to measure all the CPR quality metrics proposed in this study, except for the instantaneous ventilation rate.
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To develop a clinically relevant and qualitative brain magnetic resonance imaging (MRI) scoring system for acute stage comatose cardiac arrest patients. ⋯ A qualitative MRI scoring system effectively assessed the severity of hypoxic-ischaemic brain injury following cardiopulmonary arrest. The scoring system may provide useful prognostic information in comatose cardiopulmonary arrest patients.
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In susceptibility-weighted imaging (SWI) in the normal brain, cortical veins appear hypointense due to paramagnetic properties of deoxy-hemoglobin. Global cerebral anoxia decreases cerebral oxygen metabolism, thereby increasing oxy-hemoglobin levels in cerebral veins. We hypothesized that a lower cerebral oxygen extraction fraction in comatose patients with non-neonatal hypoxic-ischemic encephalopathy (IHE) produces a pattern of global rarefied or pseudo-diminished cortical veins due to higher oxy-hemoglobin. ⋯ The results indicate a potential diagnostic value of SWI in patients with IHE.