Resuscitation
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Randomized Controlled Trial
Level of systemic inflammation and endothelial injury is associated with cardiovascular dysfunction and vasopressor support in post cardiac arrest patients.
Post-cardiac arrest syndrome (PCAS) is characterized by a sepsis-like inflammatory response and hemodynamic instability. We investigated the associations between systemic inflammation, endothelial damage and hemodynamic parameters including vasopressor support in patients with out-of-hospital cardiac arrest (OHCA). ⋯ In comatose survivors after OHCA, increasing systemic inflammation and endothelial injury was associated with increased need of vasopressor support. Systemic inflammation, in particular IL-6, was consistently associated with vasopressor support, however endothelial injury may also play a role in PCAS associated cardiovascular dysfunction after OHCA.
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Randomized Controlled Trial Multicenter Study
Prehospital cooling to improve successful targeted temperature management after cardiac arrest: A randomized controlled trial.
Targeted temperature management (TTM) improves survival with good neurological outcome after out-of-hospital cardiac arrest (OHCA), but is delivered inconsistently and often with delay. ⋯ Prehospital cooling initiated 5min after ROSC did not increase rates of achieving a target temperature of 32-34°C within 6h of hospital arrival but was safe and increased application of TTM in hospital.
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Multicenter Study
Impact of Timing of Cardiac Arrest During Hospitalization on Survival Outcomes and Subsequent Length of Stay.
In-hospital cardiac arrest (IHCA) is common and often fatal. However, the association between timing of cardiac arrest and likelihood of survival to discharge, neurological status, and subsequent hospital length of stay (LOS) is unknown. ⋯ Most IHCA occur after 3 hospitalization days. Patients with IHCA after 3 hospital days had lower rates of survival to discharge, and, among survivors, lower rates of favorable neurological survival and longer duration of hospitalization from the time of cardiac arrest.
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2017 marks the 25th anniversary of the International Liaison Committee on Resuscitation (ILCOR). ILCOR was formed in 1992 to create a forum for collaboration among principal resuscitation councils worldwide. Since then, ILCOR has established and distinguished itself for its pioneering vision and leadership in resuscitation science. ⋯ However, local variation and contextualization of guidelines are evident by subtle differences in regional and national resuscitation guidelines. ILCOR's efforts to date have enhanced international cooperation, and progressively more transparent and systematic collection and analysis of pertinent scientific evidence. Going forward, this sets the stage for ILCOR to pursue its vision to save more lives globally through resuscitation.
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The International Liaison Committee on Resuscitation has initiated a near-continuous review of cardiopulmonary resuscitation science that replaces the previous 5-year cyclic batch-and-queue approach process. This is the first of an annual series of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations summary articles that will include the cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation in the previous year. ⋯ Insights into the deliberations of the International Liaison Committee on Resuscitation task force members are provided in Values and Preferences sections. Finally, the task force members have prioritised and listed the top 3 knowledge gaps for each population, intervention, comparator, and outcome question.