Resuscitation
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The significance of pre-arrest factors in out-of-hospital cardiac arrests (OHCA) witnessed by emergency medical services (EMS) is not well established. The purpose of this study was to assess the association between prodromal symptoms and pre-arrest clinical observations on the arresting rhythm and survival in EMS witnessed OHCA. ⋯ Pre-arrest factors are strongly associated with the arresting rhythm and survival following EMS witnessed OHCA. Potential opportunities to improve outcomes exist by way of early recognition and management of patients at risk of OHCA.
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We sought to investigate the energy requirements for patients under therapeutic hypothermia, and the relationship of energy fulfillment to patient outcome. ⋯ The EE for patients under therapeutic hypothermia was higher than expected. Meeting the energy demand may improve patient outcome, as observed in the length of ICU stay for the present study. A larger, prospective study is awaited to validate the results of our study.
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Deficits in cognitive function are a well-known dysfunction in survivors of cardiac arrest. However, data concerning memory function in this neurological vulnerable patient collective remain scarce and inconclusive. Therefore, we aimed to assess multiple aspects of retrospective and prospective memory performance in patients after cardiac arrest. ⋯ Episodic long-term memory functioning appears to be particularly impaired after cardiac arrest. In contrast, short-term memory storage, even tested via free-call, seems not to be affected. Based on cranial computed tomography we suggest that global brain ischemia rather than focal brain lesions appear to underlie these effects.
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Observational Study
Recurrent ventricular fibrillation: Experience with first responders prior to advanced life support interventions.
Following defibrillation, ventricular fibrillation (VF) frequently recurs during out-of-hospital cardiac arrest (OHCA). Prior studies have reported conflicting results regarding its association with survival. The aim of this study was to examine the impact of recurrent VF in the presence of first responders before advanced life support (ALS) interventions. ⋯ In the presence of first responders, VF recurred in 68% of patients. Recurrent VF was associated with a lower odds of survival, though its prognostic significance appeared to be blunted when considered in light of confounding variables. Recurrent VF may have significant survival implications, and further studies to assess its prognostic significance should be performed.
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This retrospective study was conducted to evaluate injuries related to cardiopulmonary resuscitation (CPR) and their associated factors using postmortem computed tomography (PMCT) and whole body CT after successful resuscitation. ⋯ PMCT is useful for evaluating complications related to chest compression. Further investigations with PMCT are needed to reduce complications and improve the quality of CPR.