Resuscitation
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Randomized Controlled Trial
Psychological wellbeing in survivors of cardiac arrest, and its relationship to neurocognitive function.
To characterise psychological wellbeing in survivors of out-of-hospital cardiac arrest (OHCA), and examine its relationship to cognitive function. ⋯ Anxiety plays an important role in determining perceived QoL in high functioning survivors, but psychological wellbeing is unrelated to cognitive function in this group. To achieve a comprehensive assessment of wellbeing, resuscitation research should consider outcomes beyond neurological function alone.
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The role of Troponin (Tn) levels in the management of patients post out-of-hospital cardiac arrest (OHCA) is unclear. ⋯ Elevated Tn levels >2ng/ml were associated with improved survival to discharge in patients post OHCA with STE. Survival in patients with no STE and Tn values >0.1ng/ml was higher when associated with diagnostic cardiac catheterization or treated with reperfusion or revascularization.
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Observational Study
Low spontaneous variability in cerebral blood flow velocity in non-survivors after cardiac arrest.
To investigate spontaneous variability in the time and frequency domain in mean flow velocity (MFV) and mean arterial pressure (MAP) in comatose patients after cardiac arrest, and determine possible differences between survivors and non-survivors. ⋯ Cerebral blood flow is altered after cardiac arrest, with decreased spontaneous fluctuations in non-survivors. Most likely, these changes are the consequence of impaired intrinsic myogenic vascular function and autonomic dysregulation.
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This study aimed to understand factors associated with paramedics' decision to attempt resuscitation in traumatic out-of-hospital cardiac arrest (OHCA) and to characterise resuscitation attempts ≤10min in patients who die at the scene. ⋯ Survival in our study was consistent with existing literature, however the large proportion of cases with resuscitation attempts ≤10min may under-represent survival in those patients that receive full resuscitation attempts.
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The probability of the return of spontaneous circulation (ROSC) and subsequent favourable outcomes changes dynamically during advanced cardiac life support (ACLS). We sought to model these changes using time-to-event analysis in out-of-hospital cardiac arrest (OHCA) patients. ⋯ The probability of ROSC and favourable subsequent outcomes changed according to a multiphasic pattern over the first 30min of ACLS, and modelling of the dynamic changes was feasible.