Resuscitation
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Review Meta Analysis
Mechanical chest compression for out of hospital cardiac arrest: Systematic review and meta-analysis.
This review of five trials investigating the efficacy of mechanical CPR devices (the LUCAS & AutoPulse) concluded that the devices demonstrate no outcome advantage compared with manual CPR, in terms of 30 day survival, survival to discharge, or neurological outcome.
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Multicenter Study
Volume versus Outcome: More Emergency Medical Services Personnel On-scene and Increased Survival after Out-of-Hospital Cardiac Arrest.
The large regional variation in survival after treatment of out-of-hospital cardiac arrest (OHCA) is incompletely explained. Communities respond to OHCA with differing number of emergency medical services (EMS) personnel who respond to the scene. The effect of different numbers of EMS personnel on-scene upon outcomes is unclear. We sought to evaluate the association between number of EMS personnel on-scene and survival after OHCA. ⋯ More EMS personnel on-scene within 15 min of 9-1-1 call was associated with improved survival of out-of-hospital cardiac arrest. It is unlikely that this finding was mediated solely by earlier CPR or earlier defibrillation.
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Review Meta Analysis
Cerebral oximetry and return of spontaneous circulation after cardiac arrest: a systematic review and meta-analysis.
The prediction of return of spontaneous circulation (ROSC) during resuscitation of patients suffering of cardiac arrest (CA) is particularly challenging. Regional cerebral oxygen saturation (rSO2) monitoring through near-infrared spectrometry is feasible during CA and could provide guidance during resuscitation. ⋯ Higher initial and average regional cerebral oxygen saturation values are both associated with greater chances of achieving ROSC in patients suffering of CA. A note of caution should be made in interpreting these results due to the small number of patients and the heterogeneity in study design: larger studies are needed to clinically validate cut-offs for guiding cardiopulmonary resuscitation.
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To determine if the quality of CPR had a significant interaction with the primary study intervention in the NIH PRIMED trial. ⋯ There was a statistically significant interaction between the quality of CPR provided, intervention, and survival to hospital discharge with mRS ≤ 3 in the NIH PRIMED trial. Quality of CPR delivered can be an underestimated effect modifier in CPR clinical trials.
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Multicenter Study
Out-of-hospital cardiac arrest in the elderly: A large-scale population-based study.
There is little information on elderly people who suffer from out-of-hospital cardiac arrest (OHCA). ⋯ Advanced age is an independent predictor of mortality in OHCA patients over 70 years of age. However, even in patients above 90 years of age, defined subsets with a survival rate of more than 10% exist. In survivors, the neurological outcome remains similar regardless of age.