Resuscitation
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Randomized Controlled Trial
Time to awakening after cardiac arrest and the association with target temperature management.
Target temperature management (TTM) at 32-36 °C is recommended in unconscious survivors of cardiac arrest. This study reports awakening in the TTM-trial. Our predefined hypotheses were that time until awakening correlates with long-term neurological outcome and is not affected by level of TTM. ⋯ Late awakening is common and often has a good neurological outcome. Time to awakening was longer in TTM33 than in TTM36, this difference could not be attributed to differences in sedative drugs administered during the first 48 h.
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Understanding the prognosis of elderly out-of-hospital cardiac arrest (OHCA) patients is vital to informing resuscitation and advanced care planning decisions. However, short-term outcomes such as survival to hospital discharge do not account for post-arrest quality of life. We describe the 12-month functional recovery and health-related quality of life (HR-QOL) of elderly OHCA survivors, including those arresting in aged care facilities. ⋯ Most elderly OHCA survivors resided independently with good functionality 12 months post-arrest. However, increasing age was associated with less favourable outcomes. New strategies are needed with regard to resuscitation in aged care facilities.
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Randomized Controlled Trial
24 vs. 72 hours of hypothermia for pediatric cardiac arrest: A pilot, randomized controlled trial.
Children surviving cardiac arrest (CA) lack proven neuroprotective therapies. The role of biomarkers in assessing response to interventions is unknown. We hypothesized that 72 versus 24 h of hypothermia (HT) would produce more favorable biomarker profiles after pediatric CA. ⋯ Serum biomarkers show promise as theragnostic tools in pediatric CA. Our biomarker and safety data also suggest that 72 h duration after pediatric CA warrants additional exploration.
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Randomized Controlled Trial
Self-learning basic life support: A randomised controlled trial on learning conditions.
To investigate whether pure self-learning without instructor support, resulted in the same BLS-competencies as facilitator-led learning, when using the same commercially available video BLS teaching kit. ⋯ Self-learning is not inferior to facilitator-led learning in the short term. Self-learning resulted in a better retention of BLS-skills three months after training compared to facilitator-led training.
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Observational Study
Severity of chronic obstructive pulmonary disease and presenting rhythm in patients with out-of-hospital cardiac arrest.
Chronic obstructive pulmonary disease (COPD) is associated with a non-shockable rhythm as presenting rhythm in out-of-hospital cardiac arrest (OHCA). Whether the severity of the underlying disease is related to presenting rhythm is unknown. We hypothesized that increased severity of COPD in OHCA patients is associated with an increased prevalence of non-shockable rhythm. ⋯ Incremental severity of COPD is associated with increasing prevalence of a non-shockable rhythm as presenting rhythm in OHCA patients.