Resuscitation
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Multicenter Study Clinical Trial
A before-after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore.
To evaluate the effects of a comprehensive dispatcher-assisted CPR (DACPR) training program on bystander CPR (BCPR) rate and the outcomes of out-of-hospital cardiac arrest (OHCA) in Singapore. ⋯ A significant increase in BCPR and ROSC was observed after the intervention. There was a trend to suggest improved survival outcomes with the intervention pending further results from the trial.
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Randomized Controlled Trial
Cerebral oxygenation in mechanically ventilated early cardiac arrest survivors: The impact of hypercapnia.
Optimal cerebral oxygenation is considered fundamental to cerebral protection in cardiac arrest (CA) patients. Hypercapnia increases cerebral blood flow and may also improve cerebral oxygenation. It is uncertain, however, whether this effect occurs in mechanically ventilated early survivors of CA. ⋯ During the early post-resuscitation period, in mechanically ventilated CA patients, mild hypercapnia increases cerebral oxygenation as assessed by NIRS. Further investigations of the effect of prolonged mild hypercapnia on cerebral oxygenation and patient outcomes appear justified.
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Multicenter Study
Automatic Cardiac Rhythm Interpretation during Resuscitation.
Resuscitation guidelines recommend different treatments depending on the patient's cardiac rhythm. Rhythm interpretation is a key tool to retrospectively evaluate and improve the quality of treatment. Manual rhythm annotation is time consuming and an obstacle for handling large resuscitation datasets efficiently. The objective of this study was to develop a system for automatic rhythm interpretation by using signal processing and machine learning algorithms. ⋯ An ECG based automatic rhythm interpreter for resuscitation has been demonstrated. The interpreter handles VT, VF and AS well, while PEA and PR discrimination poses a more difficult problem.
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Review
Cardiopulmonary resuscitation quality: Widespread variation in data intervals used for analysis.
There is a growing body of evidence for the relationship between CPR quality and survival in cardiac arrest patients. We sought to describe the characteristics of the analysis intervals used across studies. ⋯ To facilitate comparisons across studies, a standardised definition of the data analysis interval should be developed; one that maximises the amount of cases available without compromising the data's representability of the resuscitation effort.
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Multicenter Study
Prognostication of out-of-hospital cardiac arrest patients by 3-min end-tidal capnometry level in emergency department.
To evaluate the role of initial ETCO2 value in prognostication of OHCA patients in an Asian-Chinese cohort. ⋯ A 3-min ETCO2 ≤10mmHg was associated with poor prognosis and low chance of ROSC. Low ETCO2 level may have a role to reduce prolonged medically futile resuscitation.