Resuscitation
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Randomized Controlled Trial Multicenter Study
Oxygen titration after resuscitation from out-of-hospital cardiac arrest: A multi-centre, randomised controlled pilot study (the EXACT pilot trial).
Recent studies suggest the administration of 100% oxygen to hyperoxic levels following return-of-spontaneous-circulation (ROSC) post-cardiac arrest may be harmful. However, the feasibility and safety of oxygen titration in the prehospital setting is unknown. We conducted a multi-centre, phase-2 study testing whether prehospital titration of oxygen results in an equivalent number of patients arriving at hospital with oxygen saturations SpO2 ≥ 94%. ⋯ Oxygen titration post-ROSC is feasible in the prehospital environment, but incremental titration commencing at 4L/min oxygen flow may be needed to maintain an oxygen saturation >90% (NCT02499042).
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Randomized Controlled Trial
The effect of different retraining intervals on the skill performance of cardiopulmonary resuscitation in laypeople-A three-armed randomized control study.
Our study aimed to compare cardiopulmonary resuscitation (CPR) performance among laypeople with different retraining intervals. ⋯ Although young laypeople with a 3-month retraining interval had the highest pass rate when performing conventional CPR, a 6-month retraining interval may be considered for training compression-only CPR and AED when balancing outcomes and resources.
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Observational Study
Lower heart rate is associated with good one-year outcome in post-resuscitation patients.
Optimal hemodynamic goals in post-resuscitation patients are not clear. Previous studies have reported an association between lower heart rate and good outcome in patients receiving targeted temperature management (TTM) after out-of-hospital cardiac arrest. ⋯ Lower heart rate was independently associated with good neurologic outcome. Whether HR in post-resuscitation patients is a prognostic indicator or an important variable to be targeted by treatment, needs to be assessed in future prospective controlled clinical trials.
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Multicenter Study
Demographic, social, economic and geographic factors associated with long-term outcomes in a cohort of cardiac arrest survivors.
Demographic, social, economic and geographic factors are associated with increased short-term mortality after cardiac arrest. We sought to determine if these factors are additionally associated with long-term outcome differences using a detailed clinical database linked to state-wide administrative data. ⋯ There are persistent long-term outcome differences in cardiac arrest survival based on sex, income, and geographic access acute care.
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U.S. federal regulations for research involving exception from informed consent (EFIC) include stipulations for community consultation (CC) and public disclosure (PD) (FDA 21 CFR 50.24). Published descriptions of PD campaigns include letters to community leaders, media outreach, paid advertising, and community meetings. Whether or not these activities provide measurable impact is unknown, as few prior works have evaluated PD activities with probabilistic polling. The aim of this study is to use polling to assess how much public awareness PD efforts generate. ⋯ A PD campaign in scope and scale common for EFIC studies may not provide measurable impact in a community. Investigators, review boards and regulators could consider these findings when re-examining and/or creating policies for PD for EFIC studies.