Resuscitation
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To identify proteins of which depletion are associated with the poor 6-month neurological outcome of out-of-hospital cardiac arrest survivors. ⋯ The depletion of serum kallistatin at admission to the ICU was associated with the poor neurological outcome of out-of-hospital cardiac arrest survivors.
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Observational Study
Trends in the incidence and outcome of paediatric out-of-hospital cardiac arrest: A 17-year observational study.
System-based improvements to the chain of survival have yielded increases in survival from out-of-hospital cardiac arrest (OHCA) in adults. Comparatively little is known about the long-term trends in incidence and survival following paediatric OHCA. ⋯ Survival following paediatric OHCA increased in our region over a 17 year period. This was driven, in part, by improving outcomes for initial shockable arrests.
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Cardiopulmonary resuscitation guidelines suggest the lower sternal half be compressed. However, stroke volume has been assumed to be maximized by compressing the 'point' (P_max.LV) beneath which the left ventricle (LV) is at its maximum diameter. Identifying 'personalized' P_max.LV on computed tomography (CT), we derived and validated rules to estimate P_max.LV using posteroanterior chest radiography (chest_PA). ⋯ Personalized P_max.LV, which is potentially superior to the lower sternal half and feasible in CA, is estimable with chest_PA.
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Observational Study
Prognostic value of serum phosphate level in adult patients resuscitated from cardiac arrest.
Several studies have reported increased levels of phosphate after cardiac arrest. Given the relationship between phosphate level and the severity of ischaemic injury reported in previous studies, higher phosphate levels may be associated with worse outcomes. We investigated the prognostic value of phosphate level after the restoration of spontaneous circulation (ROSC) in adult cardiac arrest patients. ⋯ A higher phosphate level after ROSC was independently associated with poor outcome at hospital discharge in adult cardiac arrest patients. However, given its modest prognostic performance, phosphate level should be used in combination with other prognostic indicators.
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To design and evaluate a simple algorithm able to discriminate pulsatile rhythms from pulseless electrical activity during automated external defibrillator (AED) analysis intervals, using the ECG and the transthoracic impedance (TI) acquired from defibrillation pads. ⋯ Accurate automated detection of circulation based on TI and ECG is possible during AED analysis intervals. This functionality could potentially contribute to enhance patient's care by laypersons using AEDs.