Resuscitation
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Observational Study
Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes.
The primary aim of this study was to evaluate the association between chest compression rates and 1) arterial blood pressure and 2) survival outcomes during pediatric in-hospital cardiopulmonary resuscitation (CPR). ⋯ Non-compliance with compression rate Guidelines was common in this multicenter cohort. Among ICU patients, slightly lower rates were associated with improved outcomes compared to Guidelines.
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Measurement of chest velocity has been proposed as an alternative method to identify responder leaning during cardiopulmonary resuscitation (CPR). Leaning is defined in terms of force, but no study has tested the utility of chest velocity in the presence of force measurements that directly measure leaning. ⋯ Leaning cannot be reliably identified from vrecoil or ʋrelease, alone or in combination with currently recommended chest compression metrics in out-of-hospital CPR.
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Randomized Controlled Trial
Improving CPR quality with distributed practice and real-time feedback in pediatric healthcare providers - A randomized controlled trial.
Guideline compliant CPR is associated with improved survival for patients with cardiac arrest. Conventional Basic Life Support (BLS) training results in suboptimal CPR competency and skill retention. We aimed to compare the effectiveness of distributed CPR training with real-time feedback to conventional BLS training for CPR skills in pediatric healthcare providers. ⋯ Distributed CPR training with real-time feedback improves the compliance of AHA guidelines of quality of CPR.
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Whether regulatory T cells (Tregs) are involved in immune disorders of out-of-hospital cardiac arrest (OHCA) patients after return of spontaneous circulation (ROSC) is still unknown. We aimed to observe the expression of circulatory Tregs in OHCA patients and investigate programmed cell death-1 (PD-1) and human leucocyte antigen-DR (HLA-DR) on Tregs to evaluate the induction and activity of Tregs. ⋯ After ROSC, despite decreased circulatory Treg counts, a relative increase of Treg percentage and enhanced activity of Tregs are involved in early immune regulation of OHCA patients.
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Observational Study
Out-of-hospital cardiac arrest termination of resuscitation with ongoing CPR: An observational study.
Termination of resuscitation guidelines for out-of-hospital cardiac arrest can identify patients in whom continuing resuscitation has little chance of success. This study examined the outcomes of patients transferred to hospital with ongoing CPR. It assessed outcomes for those who would have met the universal prehospital termination of resuscitation criteria (no shocks administered, unwitnessed by emergency medical services, no return of spontaneous circulation). ⋯ Overall survival amongst patients transported to hospital with ongoing CPR was very poor. Application of the universal prehospital termination of resuscitation rule, in patients without obvious reversible causes of cardiac arrest, would have allowed resuscitation to have been discontinued at the scene for 39.2% of patients who did not survive.