Resuscitation
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Abnormal electroencephalography (EEG) patterns are common after resuscitation from cardiac arrest and have clinical and prognostic importance. Bedside continuous EEGs are not available in many institutions. We tested the feasibility of using a point-of-care system for EEG acquisition. ⋯ We studied 95 comatose post-cardiac arrest patients. Mean age was 59 (SD17) years. Most (61%) were male, few (N = 22; 23%) demonstrated shockable rhythms, and PCAC IV illness severity was present in 58 (61%). eEEG was interpretable in 57 (60%) subjects. The most common eEEG interpretations were: continuous (21%), generalized suppression (14%), burst-suppression (12%) and burst-suppression with identical bursts (10%). Seizures were detected in 2 eEEG subjects (2%). No patient with seizure or burst-suppression with identical bursts survived. cEEG demonstrated generalized suppression (31%), burst-suppression with identical bursts (27%), continuous (18%) and seizure (4%). The eEEG and cEEG demonstrated fair agreement (kappa = 0.27). Neither eEEG nor cEEG was associated with survival (p = 0.19; p = 0.11) or proximate cause of death (p = 0.14; p = 0.8) CONCLUSIONS: eEEG is feasible, although artifact often precludes interpretation. eEEG is fairly associated with cEEG and may facilitate post-cardiac arrest care.
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To review data for non-invasive imaging in the diagnosis of non-traumatic out-of-hospital cardiac arrest (OHCA). ⋯ Although non-invasive imaging is commonly performed in patients after OHCA, its diagnostic utility remains poorly characterized. Prospective studies are needed for appropriate imaging selection and their potential impact on treatment and outcome.
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Cardiopulmonary resuscitation (CPR) performed by bystanders is a key factor for out-of-hospital cardiac arrest (OHCA) survival. This study aimed to evaluate the relationship between CPR performed by off-duty medical professionals vs. laypersons and one-month survival with favorable neurological outcome after OHCA. ⋯ In Japan where the CPR training or bystander CPR has been widely disseminating, CPR by laypersons had similar effects compared to that by off-duty medical professionals. As this study could not assess the quality of bystander CPR, further studies are essential to verify the effects of the bystander CPR type on OHCA patients.
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Observational Study
Maternal out-of-hospital cardiac arrest: A retrospective observational study.
Out-of-hospital cardiac arrests (OHCAs) in pregnant women are rare events. In this study, we aimed to describe a cohort of pregnant women who experienced OHCAs in a large urban area, and received treatment by the prehospital teams in a two-tiered emergency response system. ⋯ Over half of the pregnant women who experienced OHCA were at least 20 weeks pregnant. Analysis of the prehospital medical data suggests that the current recommendations are difficult to apply in an out-of-hospital environment. Specific recommendations for this situation must be developed.
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To compare mortality and neurodevelopmental outcomes of extremely low gestational age neonates who received delivery room extensive cardiopulmonary resuscitation (DR-CPR) to those who did not require DR-CPR. ⋯ In extremely low gestational age neonates, DR-CPR was associated with higher odds of the composite outcome of mortality or neurodevelopmental impairment, mortality alone, and lower motor scores at 18 to 24 months' corrected age.