Resuscitation
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The LUCAS 2 device stores technical data that documents the chest compression process. We analyzed chest wall dimensions and mechanics stored during chest compressions on humans using data gathered with the LUCAS 2 device. ⋯ There was a large variation of the required force to achieve a compression depth of 53 mm. No correlation was seen between chest height and maximum force required to compress the chest 53 mm.
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Extracorporeal cardiopulmonary resuscitation (ECPR) promises to be an important advance in the treatment of cardiac arrest. However, ECPR involves ethical challenges that should be addressed as it diffuses into practice. ⋯ To inform decision making, patients' preferences regarding ECPR should be obtained, both from the general population and from inpatients at risk for cardiac arrest. Fair and transparent appropriate use criteria should be developed and could be informed by economic analyses.
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The accuracy of methods that classify the cardiac rhythm despite CPR artifact could potentially be improved by utilizing continuous ECG data. Our objective is to compare three approaches which use identical ECG features and differ only in their degree of temporal integration: (1) static classification, which analyzes 4-s ECG frames in isolation; (2) "best-of-three averaging," which takes the average of three consecutive static classifications successively; and (3) "adaptive rhythm sequencing," which uses hidden Markov models to model ECG segments as rhythm sequences. ⋯ In a continuous monitoring setting, adaptive rhythm sequencing was significantly more accurate than static rhythm classification during CPR.
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Little is known about outcomes of cardiopulmonary resuscitation (CPR) in pregnancy. The purpose of this study was to determine the prognostic value of pregnancy in women receiving CPR in the emergency department (ED). ⋯ Although further studies are needed, CPR in pregnancy is associated with a better prognosis compared to non-pregnant women, with trauma status being a key factor predicting outcome in the pregnant patient.