Resuscitation
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Observational Study
Use of Automated Chest Compression Devices after Out-of-Hospital Cardiac Arrest in Sweden.
To evaluate the implementation of automated chest compression cardiopulmonary resuscitation (ACC-CPR) after out-of-hospital cardiac arrest (OHCA) in Sweden during the years 2011 through 2015. The association between ACC-CPR and 30-day survival was studied as a secondary objective. ⋯ The use of ACC devices varied significantly between Swedish regions and overall survival to 30days was low among patients receiving ACC-CPR. Although measured and unmeasured confounding might explain our finding of lower survival rates for patients exposed to ACC-CPR, specific guidelines recommending when and how ACC-CPR should be used are warranted as there might be circumstances where these devices do more harm than good.
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Few data are available on the use of brainstem auditory evoked potentials (BAEPs) in combination with other electrophysiological tools to assess prognosis of comatose survivors from cardiac arrest (CA). ⋯ In this series of patients after CA, at least one of the BAEP waves was absent bilaterally in half the survivors; however, their use for prediction of poor neurological outcome remains limited.
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The aim was to investigate the clinical performance of two different types of automated external defibrillators (AEDs). ⋯ There were significant differences in sensitivity and specificity between the two different AEDs. A higher sensitivity of AED B was associated with a lower specificity while a higher specificity of AED A was associated with a lower sensitivity. AED manufacturers should work to improve the algorithms. In addition, AED use should always be reviewed with a routine for giving feedback, and medical personnel should be aware of the specific strengths and shortcomings of the device they are using.
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Multicenter Study
Post-Resuscitation Arterial Oxygen and Carbon Dioxide and Outcomes after Out-of-Hospital Cardiac Arrest.
To determine if arterial oxygen and carbon dioxide abnormalities in the first 24h after return of spontaneous circulation (ROSC) are associated with increased mortality in adult out-of-hospital cardiac arrest (OHCA). ⋯ In the first 24h after ROSC, abnormal post-arrest oxygen and carbon dioxide tensions are associated with increased out of-hospital cardiac arrest mortality.
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Observational Study
Quality of bystander cardiopulmonary resuscitation during real-life out-of-hospital cardiac arrest.
Cardiopulmonary resuscitation (CPR) can increase survival in out-of-hospital cardiac arrest (OHCA). However, little is known about bystander CPR quality in real-life OHCA. ⋯ The median CPR performed by bystanders using AEDs with audio-feedback in OHCA was within guideline recommendations without deterioration over time. Compression depth had poorer quality compared with other parameters. To improve bystander CPR quality, focus should be on proper compression depth and minimizing pauses.