Resuscitation
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The goal of our study is to determine if prehospital dual defibrillation (DD) is associated with better neurologically intact survival in out-of-hospital cardiac arrest. ⋯ Our retrospective cohort analysis on the prehospital use of DD in OHCA found no association with neurologically intact survival. Case-control studies are needed to further evaluate the efficacy of DD in the prehospital setting.
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MicroRNAs (miRNAs) have regulatory functions in organs critical in resuscitation from sudden cardiac arrest due to ventricular fibrillation (VF-SCA); therefore, circulating miRNAs may be markers of VF-SCA outcome. ⋯ Circulating miRNAs expressed in heart, brain, and other tissues differ between VF-SCA cases and controls and are related to resuscitation outcomes. Measurement of miRNAs may clarify mechanisms underlying resuscitation, improve prognostication, and guide development of therapies. Results require replication.
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Bradyasystolic heart rhythms are often recorded in out-of-hospital cardiac arrest (OHCA). Atrioventricular (AV) conduction disorders might lead to OHCA, but the prevalence of AV-conduction disorders and other bradyasystolic rhythms in OHCA is unknown. These patients might benefit from pre-hospital pacing. We aimed to determine the prevalence of different types of bradyasystolic heart rhythms in OHCA, including third degree AV-block, and document survival rates. ⋯ In bradyasystolic OHCA, 16% of all patients present with third degree AV-block, but survival for these and other bradyasystolic patients remains poor. Pacing is seldom initiated, often delayed, and rarely beneficial.
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Actual application of public-access automated external defibrillator (AED) pads to patients with an out-of-hospital cardiac arrest (OHCA) by the public has been poorly investigated. ⋯ The application of public-access AEDs leads to favourable outcomes after an OHCA, but utilisation of available equipment remains insufficient, and varies considerably according to the location of the OHCA event. Alongside disseminating public-access AEDs, further strategic approaches for the deployment of AEDs at the scene, as well as basic life support training for the public are required to improve survival rates after OHCAs.
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To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still …, and move on' from a societal perspective. ⋯ The intervention 'Stand still …, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended.