Resuscitation
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To date, no clinical test is able to predict cognitive and functional outcome of cardiac arrest survivors. Improvement of auditory discrimination in acute coma indicates survival with high specificity. Whether the degree of this improvement is indicative of recovery remains unknown. Here we investigated if progression of auditory discrimination can predict cognitive and functional outcome. ⋯ Progression of auditory discrimination during coma provides early indication of future recovery of cognitive functions. The degree of improvement is informative of the degree of functional impairment. If confirmed in a larger cohort, this test would be the first to predict detailed outcome at the single-patient level.
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To compare functional survival (discharge cerebral performance category 1 or 2) among victims of out-of-hospital cardiac arrest (OHCA) who had resuscitations performed using mechanical chest compression (mech-CC) devices vs. those using manual chest compressions (man-CC). ⋯ Mechanical chest compression device use was associated with lower rates of functional survival in this propensity score analysis, controlling for Utstein variables and early return of spontaneous circulation.
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Observational Study
Echocardiographic Left Ventricular Systolic Dysfunction Early after Resuscitation from Cardiac Arrest Does Not Predict Mortality or Vasopressor Requirements.
Echocardiographic abnormalities are common after resuscitation from cardiac arrest. The association between echocardiographic findings with vasopressor requirements and mortality are not well described. We sought to determine the associations between echocardiographic abnormalities and mortality, vasopressor requirements and organ failure after cardiac arrest. ⋯ Echocardiographic parameters (including LVEF) were not associated with inpatient mortality after cardiac arrest. Vasopressor requirements and organ failure severity were not associated with multiple echocardiographic markers of systolic function.
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Neonatal encephalopathy (NE) of hypoxic-ischaemic origin may cause death or life-long disability which is reduced by therapeutic hypothermia (TH). Our objective was to assess HR response in infants undergoing TH after perinatal asphyxia. ⋯ In NE, TH decreases HR the first day of life. HR remained lower during TH, but increased during the last day of TH. Infants with poor outcome have higher HR.
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Observational Study
Combined use of the National Early Warning Score and D-dimer levels to predict 30-day and 365-day mortality in medical patients.
To investigate the combined use of NEWS and D-dimer levels to predict the 30-day and 365-day mortality rates of a cohort of Danish patients with complete follow-up. ⋯ The combination of NEWS score<3 and D-dimer levels below 0.50mgL(-1) appears to identify patients of low risk of mortality within 30 days and, therefore, may prove to be a powerful risk assessment tool for acutely ill medical patients.