Resuscitation
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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.
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Observational Study
Impact of urgent coronary angiography on mid-term clinical outcome of comatose out-of-hospital cardiac arrest survivors presenting without ST-segment elevation.
Timing of coronary angiography (CAG) is still controversial in the out-of-hospital cardiac arrest survivors who present without ST-segment elevation. ⋯ Performing an urgent CAG in comatose cardiac arrest survivors without ST-segment elevation was not associated with better clinical and neurological outcome as compared to the initially conservative approach.
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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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Multicenter Study Observational Study
The relationship between age and outcome in out-of-hospital cardiac arrest patients.
To determine the association between age and outcome in a large multicenter cohort of out-of-hospital cardiac arrest patients. ⋯ Advanced age is associated with outcomes in out-of-hospital cardiac arrest. We did not identify a specific age threshold beyond which the chance of a meaningful recovery was excluded.