Resuscitation
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Multicenter Study
Detailed analysis of health-related quality of life after out-of-hospital cardiac arrest.
To describe the detailed health-related quality of life (HRQoL) in survivors from the TTM-trial and to investigate potential differences related to sex and age. ⋯ Many OHCA survivors demonstrated impaired function in HRQoL at a domain level, despite most patients reporting an acceptable general HRQoL. Females reported worse HRQoL than males. Older age was associated with a worse Physical Functioning but better Vitality and Mental Health. Role-Physical and Role-Emotional aspects of health were especially affected, even when effects of age and sex where accounted for.
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Observational Study
The effect of dispatcher-assisted cardiopulmonary resuscitation on early defibrillation and return of spontaneous circulation with survival.
Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) programs are implemented to augment bystander CPR and improve outcomes of patients with out-of-hospital cardiac arrest (OHCA). To understand the pathway of how DA-CPR improves outcomes of OHCA, we aimed to evaluate the effect of DA-CPR on defibrillation and return of spontaneous circulation (ROSC) with survival to hospital discharge within 90 min. ⋯ Compared with no bystander CPR provided, both bystander CPR with or without dispatcher assistance were associated with defibrillation and ROSC leading to survival to discharge in patients with witnessed OHCA.
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Multicenter Study Observational Study
Immediate versus early coronary angiography with targeted temperature management in out-of-hospital cardiac arrest survivors without ST-segment elevation: A propensity score-matched analysis from a multicenter registry.
The optimal coronary angiography (CAG) timing in out-of-hospital cardiac arrest (OHCA) survivors without ST-segment elevation (STE) for good neurologic outcome remains unknown. This study aimed to evaluate whether immediate versus early CAG impacts neurological outcomes of OHCA survivors without STE. ⋯ Coronary artery stenosis was found in 42.7% of TTM-treated non-STE OHCA patients with CAG within 24 h, but there was no clear neurological benefit of immediate versus early CAG.
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Early enteral nutrition (EN) is recommended for critically ill patients; however, few reports have examined early EN for patients who received targeted temperature management (TTM) after out-of-hospital cardiac arrest (OHCA). We investigated the effectiveness and safety of early EN for patients who received TTM after OHCA. ⋯ Among patients who received TTM after OHCA, there was no significant association between early EN and 30-day mortality; however, early EN could be beneficial for patients with a low BMI.
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We investigated the change in pupil size and pupil light reflex (PLR) using a pupillography capable of continuous measurement both during CPR and immediately following the return-of-spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) comatose patients in an emergency department. ⋯ Our study demonstrated that measurement of the continuous pupillary response can be feasible. Patients with the presence of PLR following ROSC had better outcomes.