Resuscitation
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Randomized Controlled Trial Multicenter Study
Optimizing CPR performance with CPR coaching for pediatric cardiac arrest: A randomized simulation-based clinical trial.
To determine if integrating a trained CPR Coach into resuscitation teams can improve CPR quality during simulated pediatric cardiopulmonary arrest (CPA). ⋯ In the presence of CPR feedback technology, the integration of a trained CPR coach into resuscitation teams enhances CPRquality metrics associated with improved survival outcomes from pediatric cardiac arrest.
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Resuscitation of refractory out-of-hospital ventricular fibrillation/ventricular tachycardia (VF/VT) cardiac arrest using extracorporeal membrane oxygenation (ECMO) establishes a complex patient population. We aimed to describe the critical care strategies and outcomes in this population. ⋯ Multi-system organ failure is ubiquitous but treatable with adequate hemodynamic support. Neurologic recovery was prolonged requiring delayed prognostication. Immediate 24/7 availability of surgical and medical specialty expertise was required to achieve 48% functionally intact survival.
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Review Meta Analysis
One-year survival after in-hospital cardiac arrest: A systematic review and meta-analysis.
In-hospital cardiac arrest is a major adverse event with an incidence of 1-6/1000 admissions. It has been poorly researched and data on survival is limited. The outcome of interest in IHCA research is predominantly survival to discharge, however recent guidelines warrant for more long-term outcomes. In this systematic review we sought to quantitatively summarize one-year survival after in-hospital cardiac arrest. ⋯ One-year survival after in-hospital cardiac arrest is poor. Survival is higher in patients admitted to cardiac wards. The time trend between 1985-2018 has shown a modest improvement in one-year survival rates. Research into IHCA population characteristics might elicit the issue of heterogeneity and stagnated survival over the past decades.
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The objectives were: 1) replicate key elements of Head Up (HUP) cardiopulmonary resuscitation (CPR) physiology in a traditional swine model of ventricular fibrillation (VF), 2) compare HUP CPR physiology in pig cadavers (PC) to the VF model 3) develop a new human cadaver (HC) CPR model, and 4) assess HUP CPR in HC. ⋯ HUP CPR decreased ICP while increasing CerPP in pigs in VF as well as in PC and HC CPR models. This first-time demonstration of HUP CPR physiology in humans provides important implications for future resuscitation research and treatment.
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Review Meta Analysis
Gray matter to white matter ratio for predicting neurological outcomes in patients treated with target temperature management after cardiac arrest: A systematic review and meta-analysis.
This study aimed to evaluate the prognostic accuracy of the gray matter to white matter ratio (GWR) in predicting neurological outcomes in post-cardiac arrest patients treated with target temperature management. ⋯ GWR in the early cranial computed tomography scan had high prognostic value in predicting poor neurological outcomes in post-cardiac arrest patients. The BG GWR had the highest prognostic accuracy when compared to other locations of the brain.