Resuscitation
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Editorial Comment
Debunking another CPR myth: Lay the patient flat, or head up CPR?
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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 purpose of this systematic review is to provide up-to-date evidence on effectiveness of antiarrhythmic drugs for shockable cardiac arrest to help inform the 2018 International Liaison Committee on Resuscitation Consensus on Science with Treatment Recommendations. ⋯ The high level evidence supporting the use of antiarrhythmic drugs during CPR for shockable cardiac arrest is limited and showed no benefit for critical outcomes of survival at hospital discharge, survival with favorable neurological function and long-term survival. Future high quality research is needed to confirm these findings and also to evaluate the role of administering antiarrhythmic drugs in children with shockable cardiac arrest, and in adults immediately after ROSC.
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Electroencephalography (EEG) is a key modality for assessment of prognosis following cardiac arrest (CA); however, whether continuous EEG (cEEG) is superior to routine intermittent EEG (rEEG) remains debated. We examined the impact of cEEG (>18 h) vs. rEEG (<30 min) on outcome in comatose CA patients as part of multimodal prognostication. ⋯ Our data suggest that cEEG does not confer any advantage over intermittent rEEG regarding outcome in patients with CA, and does not influence the time to death.
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Maternal mortality has risen in the United States in the twenty-first century, yet large cohort data of maternal cardiac arrest (MCA) are limited. ⋯ Maternal survival at hospital discharge in this cohort was less than 50%, lower than rates reported in other epidemiological datasets. More research is required in maternal resuscitation science and translational medicine to continue to improve outcomes and understand maternal mortality.