Resuscitation
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Multicenter Study
Outcomes of asphyxial cardiac arrest patients who were treated with therapeutic hypothermia: A multicenter retrospective cohort study.
While therapeutic hypothermia (TH) is in clinical use, its efficacy in certain patient groups is unclear. This study was designed to describe the characteristics and outcomes of patients with out-of-hospital cardiac-arrest (OHCA) caused by asphyxia, who were treated with TH. ⋯ About half of patients who underwent TH after asphyxial cardiac arrest survived, but a very small number showed a good neurologic outcome. The TH maintenance times were not uniform in these patients. Additional research regarding both the appropriate TH guidelines for patients with asphyxial cardiac arrest and improvement of their neurologic outcome is needed.
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Randomized Controlled Trial Multicenter Study Comparative Study
TARGET TEMPERATURE MANAGEMENT OF 33°C AND 36°C IN PATIENTS WITH OUT-OF-HOSPITAL CARDIAC ARREST WITH INITIAL NON-SHOCKABLE RHYTHM - A TTM SUB-STUDY.
Despite a lack of randomized trials in comatose survivors of out-of-hospital cardiac arrest (OHCA) with an initial non-shockable rhythm (NSR), guidelines recommend induced hypothermia to be considered in these patients. We assessed the effect on outcome of two levels of induced hypothermia in comatose patient resuscitated from NSR. ⋯ Comatose patients after OHCA with initial NSR continue to have a poor prognosis. We found no effect of targeted temperature management at 33°C compared to 36°C in these patients.
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Multicenter Study
Quantitative relationship between end-tidal carbon dioxide and CPR quality during both in-hospital and out-of-hospital cardiac arrest.
Cardiopulmonary resuscitation (CPR) guidelines recommend the administration of chest compressions (CC) at a standardized rate and depth without guidance from patient physiologic output. The relationship between CC performance and actual CPR-generated blood flow is poorly understood, limiting the ability to define "optimal" CPR delivery. End-tidal carbon dioxide (ETCO2) has been proposed as a surrogate measure of blood flow during CPR, and has been suggested as a tool to guide CPR despite a paucity of clinical data. We sought to quantify the relationship between ETCO2 and CPR characteristics during clinical resuscitation care. ⋯ ETCO2 values generated during CPR were statistically associated with CC depth and ventilation rate. Further studies are needed to assess ETCO2 as a potential tool to guide care.