Resuscitation
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It was hypothesized that the pattern of coronary occlusion (thrombus composition) might contribute to the onset of ventricular arrhythmia and sudden cardiac death (SCD) in myocardial infarction (MI). ⋯ Composition of intracoronary thrombi in STEMI patients does not differ between those presenting with and without SCD. Time from symptom onset to coronary reperfusion seems to be the strongest factor influencing thrombus composition in MI.
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To investigate trends in survival to hospital discharge, in-hospital expenditures, and post-acute-care disposition following out-of-hospital cardiac arrest (OHCA) in the United States. ⋯ Overall survival to discharge following out-of-hospital cardiac arrest remained static between 1995 and 2013. Renewed national efforts are needed to warrant better knowledge translation and wider implementation of the best available science in order to improve outcomes.
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Sudden cardiac arrest (SCA), confirmed absence of cardiac mechanical activity, is the leading cause of heart-related death in the US. Almost 85% of SCA occur out-of-hospital (OHCA), with very poor rates of return of spontaneous circulation (ROSC) and survival to hospital discharge. We sought to determine if diabetes status was associated with survival or ROSC following an OHCA. ⋯ This is the first Canadian study to examine the association between diabetes status and OHCA outcomes. Our findings suggest that diabetes status prior to arrest is associated with decreased survival. The growing prevalence of diabetes globally suggests a future burden related to OHCAs.
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Observational Study
Incidence and prognosis of nosocomial infection after recovering of cardiac arrest in children.
to analyze the incidence of infection in children who have suffered an in-hospital cardiac arrest (CA) and the association with mortality. ⋯ The frequency of infection in children after recovering of a cardiac arrest is high. There were no statistically significant differences in mortality between patients with and without infection after ROSC.
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Amplitude spectral area (AMSA), an index for analysing ventricular fibrillation (VF) waveforms, is thought to predict the return of spontaneous circulation (ROSC) after electric shocks, but its validity is unconfirmed. We developed an equation to predict ROSC, where the change in AMSA (ΔAMSA) is added to AMSA measured immediately before the first shock (AMSA1). We examine the validity of this equation by comparing it with the conventional AMSA1-only equation. ⋯ Post-shock ROSC was accurately predicted by adding ΔAMSA to AMSA1. AMSA-based ROSC prediction enables application of electric shock to only those patients with high probability of ROSC, instead of interrupting chest compressions and delivering unnecessary shocks to patients with low probability of ROSC.