Resuscitation
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Randomized Controlled Trial Multicenter Study
Arterial Blood Gases during and their Dynamic Changes after Cardiopulmonary Resuscitation: A Prospective Clinical Study.
An arterial blood gas analysis (ABG) yields important diagnostic information in the management of cardiac arrest. This study evaluated ABG samples obtained during out-of-hospital cardiopulmonary resuscitation (OHCPR) in the setting of a prospective multicenter trial. We aimed to clarify prospectively the ABG characteristics during OHCPR, potential prognostic parameters and the ABG dynamics after return of spontaneous circulation (ROSC). ⋯ Our findings suggest that adequate ventilation and oxygenation deserve more research and clinical attention in the management of cardiac arrest and that oxygen uptake improves within minutes after ROSC. Hyperventilation resulting in arterial hypocapnia is not a major problem during OHCPR.
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Randomized Controlled Trial Multicenter Study
Minimizing Pre- and Post-Shock Pauses During the Use of an Automatic External Defibrillator by two Different Voice Prompt protocols. A randomized controlled trial of a bundle of measures.
Previous large retrospective analyses have found an association between duration of peri-shock pauses in cardiopulmonary resuscitation (CPR) and survival. In a randomized trial, we tested whether shortening these pauses improves survival after out-of-hospital cardiac arrest (OHCA). ⋯ http://www.isrctn.com unique identifier: ISRCTN72257677.
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Multicenter Study Comparative Study
A comparison of therapeutic hypothermia and strict therapeutic normothermia after cardiac arrest.
In a recent high-quality randomised controlled trial (RCT), strict therapeutic normothermia (STN) following cardiac arrest with coma resulted in similar outcomes to therapeutic hypothermia (TH). We aimed to test the feasibility, reproducibility, and safety of the STN protocol outside of its RCT context. ⋯ The STN protocol was successfully reproduced outside of an RCT and appeared associated with fewer complications than the TH protocol. Our findings imply that the STN protocol may offer clinical advantages over the TH protocol.
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Multicenter Study
Admission of out-of-hospital cardiac arrest victims to a high volume cardiac arrest center is linked to improved outcome.
Cardiac arrest centers have been associated with improved outcome for patients after cardiac arrest. Aim of this study was to investigate the effect on outcome depending on admission to high-, medium- or low volume centers. ⋯ High frequency of post-cardiac arrest treatment in a specialized center seems to be an independent predictor for favorable outcome in an unselected population of patients after out of hospital cardiac arrest.
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Multicenter Study
Automated external defibrillation skills by naive schoolchildren.
Early defibrillation should achieve the highest survival rates when applied within the first minutes after the collapse. Public access defibrillation programs have increased the population awareness of the importance of defibrillation. Schoolchildren should be trained in basic life support (BLS) skills and some countries have included BLS in their school syllabus. However, little is known of the current knowledge and ability of schoolchildren to use an automated external defibrillator (AED). ⋯ Around 20% of schoolchildren without prior training are able to use an AED correctly in less than 3min following the device's acoustic and visual instructions. However, only one-fifth of those who showed success managed to complete the procedure satisfactorily. These facts should be considered in order to provide a more accurate definition and effective implementation of BLS/AED teaching and training at schools.