Resuscitation
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To determine the number of potential deceased organ donors from out-of- hospital cardiac arrest cases (OHCA) attended by public physician-led emergency medical services in Spain, based on data recorded in the nationwide Spanish OHCA Registry (OHSCAR). ⋯ Many potential donors are missed in current clinical practice. uDCD programs are few and underused even in a country with high rates of organ transplantation.
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To compare short- and long-term survival in patients admitted to hospital after acute myocardial infarction (AMI) with and without out-of-hospital cardiac arrest (OHCA). ⋯ Long-term survival after OHCA due to AMI was good, with 49% of admitted patients being alive after eight years. Although short-term mortality remained high, OHCA patients alive after 30days had similar long-term risk as AMI patients without OHCA.
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Comparative Study
A Retrospective Comparison of Survivors and Non-Survivors of Massive Pulmonary Embolism Receiving Veno-arterial Extracorporeal Membrane Oxygenation Support.
While the optimal care of patients with massive pulmonary embolism (PE) is unclear, the general goal of therapy is to rapidly correct the physiologic derangements propagated by obstructive clot. Extracorporeal membrane oxygenation (ECMO) in this setting is promising, however the paucity of data limits its routine use. Our institution expanded the role of ECMO as an advanced therapy option in the initial management of massive PE. The purpose of this project was to evaluate ECMO-treated patients with massive PE at an academic medical center and report shortterm mortality outcomes. ⋯ The practical approach of utilizing ECMO for massive PE is to reserve it for those who would receive the greatest benefit. Patients with poor perfusion, for example from cardiac arrest, may gain less benefit from ECMO. Our findings indicate that a serum lactate >6mmol/L may be an indicator of worse prognosis. Finally, in our patient population, catheter-directed thrombolytics was effectively combined with ECMO.
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Multicenter Study
An automatic system for the comprehensive retrospective analysis of cardiac rhythms in resuscitation episodes.
An automatic resuscitation rhythm annotator (ARA) would facilitate and enhance retrospective analysis of resuscitation data, contributing to a better understanding of the interplay between therapy and patient response. The objective of this study was to define, implement, and demonstrate an ARA architecture for complete resuscitation episodes, including chest compression pauses (CC-pauses) and chest compression intervals (CC-intervals). ⋯ A general ARA architecture was defined and demonstrated on a comprehensive OHCA dataset. Results showed that semi-automatic resuscitation rhythm annotation, which may involve further revision/correction by clinicians for quality assurance, is feasible. The performance (UMS) dropped significantly during CC-intervals and sensitivity was lowest for PEA.