Resuscitation
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Randomized Controlled Trial Multicenter Study
Stratifying comatose postanoxic patients for somatosensory evoked potentials using routine EEG.
Multimodal neurological prognostication is recommended for comatose patients after cardiac arrest. The absence of cortical N20-potentials in a somatosensory evoked potential (SSEP) examination reliably predicts poor outcome, but presence of N20-potentials have limited prognostic value. A benign routine electroencephalogram (EEG) may identify patients with a favourable prognosis who are likely to have present N20-potentials. ⋯ All patients with a benign EEG had present N20-potentials, suggesting that SSEP may be omitted in these patients to save resources. SSEP is useful in patients with a malignant or highly malignant EEG since these patterns are associated with both present and absent N20-potentials.
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6.5-9 million newborns worldwide require resuscitation at birth annually. During neonatal resuscitation, inaccurate or slow heart rate (HR) assessments may significantly increase risk of infant mortality or morbidity. Therefore fast, accurate, and effective HR assessment tools are critical for neonatal resuscitation. ⋯ While electrocardiography is faster to assess HR at birth and more reliable to detect HR changes compared to other recommended technologies, practice should not exclusively rely on ECG. While novel technologies could support HR assessment, no studies validate their clinical efficacy during neonatal resuscitation.
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To provide an overview of cadaver models for cardiac arrest and to identify the most appropriate cadaver model to improve cardiopulmonary resuscitation through a systematic review. ⋯ Four types of cadaver models are used in cardiac arrest research. The great heterogeneity of these models coupled with unequal quality in reporting makes comparisons between studies difficult. There is a need for uniform reporting and standardisation of human cadaver models in cardiac arrest research.
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Multicenter Study
Regional trends in In-hospital Cardiac Arrest following sepsis-related admissions and subsequent mortality.
Previous studies have reported regional variation in either the incidence or outcomes of sepsis or In-hospital Cardiac Arrest (IHCA) discretely; however, regional variations in the incidence and outcomes of sepsis-associated IHCA (SA-IHCA) have never been studied. ⋯ This nationwide analysis demonstrates that the highest incidence of SA-IHCA is in the Southern region of the US whereas the associated in-hospital mortality was highest in the West. The incidence of SA-IHCA is rising in the Midwest and South from 2007 to 2014. Despite significant advances in the treatment of sepsis and IHCA, there has been no significant improvement in the incidence of SA-IHCA and subsequent survival in any US geographic region from 2007 to 2014.
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Multicenter Study
Trends in survival from out-of-hospital cardiac arrests defibrillated by paramedics, first responders and bystanders.
Although survival from out-of-hospital cardiac arrest (OHCA) is increasing, little is known about the long-term trends in survival for patients defibrillated by first responders and bystanders. ⋯ OHCA patients initially defibrillated by bystanders yielded the largest improvements in survival over time.