Resuscitation
-
Multicenter Study
Long-Term Neurologic Outcomes following Paediatric Out-of-Hospital Cardiac Arrest.
Evaluate long-term neurologic outcome for paediatric survivors of OHCA. ⋯ In this cohort study of neurologic outcomes for paediatric OHCA survivors, a favorable initial PCPC score was highly associated with stable long-term neurological outcomes. Those with poor neurologic status at initial discharge were unlikely to improve and were at greatest risk to die in follow-up. Future studies should focus on improving neurologic outcomes and prospectively evaluating the long-term neurologic course.
-
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.
-
Target temperature management (TTM) after cardiac arrest (CA) improves outcome in patients with acute coronary syndrome (ACS). Previous data point to an interaction between hypothermia and drug metabolism, potentially impacting on platelet function in patients on antiplatelet therapy. ⋯ Inhibition of platelet function is significantly lessened in TTM at 33°C, likely due to reduced clopidogrel absorption. Patients with TTM might thus have a higher risk for further cardiovascular events despite antiplatelet therapy with clopidogrel.
-
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.
-
Randomized Controlled Trial
Ventricular ectopic burden in comatose survivors of out-of-hospital cardiac arrest treated with targeted temperature management at 33°C and 36°C.
Life threatening arrhythmias are increasingly frequent with lower body temperature. While targeted temperature management (TTM) with mild hypothermia following out-of-hospital cardiac arrest (OHCA) is generally considered safe and has been suggested as a potential antiarrhythmic add-on therapy, it is unknown whether the level of TTM affects the burden of ventricular ectopic activity. We sought to assess the ventricular ectopic burden between patients treated with TTM at 33°C or 36°C for 24h. ⋯ Ventricular ectopic activity was reduced in comatose OHCA-survivors treated with TTM at 36°C compared to 33°C. Higher numbers of pre-hospital defibrillations were associated with higher incidence of ventricular ectopic activity.