Resuscitation
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Therapeutic hypothermia (TH) has increasingly become a part of the current standard of care for treating patients with cardiac arrest (CA). However, little is known regarding the association between TH and long-term quality of life (QoL) in adult survivors of CA. We conducted a systematic review to investigate the association between TH implementation and long-term QoL outcomes in adult survivors of CA following hospital discharge. ⋯ In this systematic review, the included studies do not suggest any association between TH implementation in CA with long-term QoL in CA survivors. Further larger scale studies are needed to investigate the sustainability of TH effects long term in this patient population.
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Observational Study
The influences of adrenaline dosing frequency and dosage on outcomes of adult in-hospital cardiac arrest: A retrospective cohort study.
To investigate the influence of dosing frequency and dosage of adrenaline on outcomes of cardiopulmonary resuscitation (CPR). ⋯ Higher adrenaline average dosing frequency may be associated with worse outcomes after CPR. Besides, according to current recommendations, patients with BW above 82.5kg may not receive adequate dose of adrenaline.
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Potassium cardioplegia-induced transient asystole may conserve myocardial energy, foster chemical defribrillation, and improve VF arrest outcome. A trial of potassium infusion with or without calcium reversal was conducted to test for improvement in intra-arrest VF waveform and post-ROSC hemodynamics. ⋯ Chemical defibrillation and ROSC are possible post potassium-induced asystole. Potassium followed by calcium reversal, but not potassium alone, led to ROSC and post-ROSC hemodynamics comparable to recommended therapy.
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Observational Study
Quantitative pupillometry and transcranial Doppler measurements in patients treated with hypothermia after cardiac arrest.
Predicting outcome after cardiac arrest (CA) is particularly difficult when therapeutic hypothermia (TH) is used. We investigated the performance of quantitative pupillometry and transcranial Doppler (TCD) in this context. ⋯ PLR measurements might be informative in the prediction of outcome of post-CA patients even under sedation and hypothermia.
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To date, 72% of variability in survival following out-of-hospital cardiac arrest (OHCA) is explained by the Utstein variables. Whether neighborhood factors further influence a return of spontaneous circulation or survival after OHCA is poorly understood. ⋯ Residential neighborhood factors marginally improve discrimination for outcomes after an OHCA, beyond the Utstein variables. Further research should explore the influence of other currently unmeasured neighborhood factors on OHCA outcomes.