Resuscitation
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Randomized Controlled Trial Multicenter Study
Osborn waves following out-of-hospital cardiac arrest-Effect of level of temperature management and risk of arrhythmia and death.
The Osborn or J-wave, an upright deflection of the J-point on the electrocardiogram (ECG), is often observed during severe hypothermia. A possible relation between Osborn waves (OW) and increased risk of ventricular arrhythmia has been reported. We sought to determine whether the level of targeted temperature management (TTM) following out-of-hospital cardiac arrest (OHCA) affects the prevalence of OW and to assess the associations between OW and risk of ventricular arrhythmia and death. ⋯ OW are frequent during TTM, particularly in patients treated with 33 °C. OW are not associated with increased risk of ventricular arrhythmia, and may be considered a benign physiological phenomenon, associated with lower mortality in univariable analyses.
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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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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).