Resuscitation
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Multicenter Study
Adherence to advanced cardiovascular life support (ACLS) guidelines during in-hospital cardiac arrest is associated with improved outcomes.
Identifying modifiable factors associated with survival following in-hospital cardiac arrest is crucial. The purpose of this study was to determine the extent to which adherence to the 2010 American Heart Association (AHA) Advanced Cardiac Life Support (ACLS) guidelines in their entirety affects patient outcomes. In addition, we explored the role of code leader training level on patient outcomes. ⋯ We found that higher numbers of deviations from ACLS guidelines were associated with a lower likelihood of ROSC and survival to hospital discharge. These findings emphasize the importance of adherence to ACLS guidelines and the need for training healthcare personnel in resuscitation guidelines in order to improve outcomes for victims of in-hospital cardiac arrest.
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Multicenter Study
Resuscitation registers: How many active registers are there and how many collect data on paediatric cardiac arrests?
Cardiac arrest, particularly in children, often has a poor outcome and international guidelines highlight significant gaps in the evidence base for effective resuscitation. Whilst randomised controlled trials for some interventions can be justified, they are not appropriate for many aspects of resuscitation. Therefore, guidelines must use other sources of data such as epidemiological evidence from cardiac arrest registries, to improve the efficacy of resuscitation. The aim of our study was to identify existing national cardiac arrest registries and document key information about the registries, including whether they contain data on paediatric arrests. ⋯ To our knowledge this report contains the most complete list of active national and large regional cardiac arrest registries. Register data support current guidelines on effective resuscitation however, even the largest registries include relatively small numbers, particularly of paediatric events. A less fragmented approach has the potential to improve the utility of registration data for the benefit of patients.
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Prognosticating outcome after cardiac arrest(CA) requires a multimodal approach. However, evidence regarding combinations of methods is limited. We evaluated whether the combination of electroencephalography(EEG), somatosensory evoked potentials(SEPs) and brain computed tomography(CT) could predict poor outcome. ⋯ In this population, in which life-sustaining treatments were never suspended, the combination of EEG, SEPs and brain CT improved the sensitivity, maintaining the specificity of poor outcome prediction.
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Review Meta Analysis
Impact of adult advanced cardiac life support course participation on patient outcomes-A systematic review and meta-analysis.
The objective of this study was to evaluate the impact of the prior participation of one or more members of the adult resuscitation team in an accredited advanced life support course on patient outcomes (return of spontaneous circulation, survival to discharge, survival to 30 days, and survival to 1 year). ⋯ The inference of this review is that the advanced life support courses have a positive impact upon return of spontaneous circulation and survival to hospital discharge. The data also implies a positive impact upon survival to 30 days of adult cardiac arrest patients.