Resuscitation
-
Multicenter Study Comparative Study Observational Study
Comparison of video laryngoscopy versus direct laryngoscopy for intubation in emergency department patients with cardiac arrest: A multicentre study.
To compare the tracheal intubation performance between video laryngoscopy (VL) and direct laryngoscopy (DL) in patients with cardiac arrest in the ED. ⋯ Based on large multicentre prospective data of ED patients with cardiac arrest, the use of VL was associated with a higher first-attempt success rate compared to DL, with a better glottic visualisation and lower oesophageal intubation rate.
-
Multicenter Study
Differential association of subtypes of epileptiform activity with outcome after cardiac arrest.
Epileptiform activity is common after cardiac arrest, although intensity of electroencephalographic (EEG) monitoring may affect detection rates. Prior work has grouped these patterns together as "malignant," without considering discrete subtypes. We describe the incidence of distinct patterns in the ictal-interictal spectrum at two centers and their association with outcomes. ⋯ We found high rates of epileptiform EEG findings, regardless of intensity of EEG monitoring. The association of distinct ictal-interictal EEG findings with outcome was variable.
-
Randomized Controlled Trial
Wireless and continuous monitoring of vital signs in patients at the general ward.
Clinical deterioration regularly occurs in hospitalized patients potentially resulting in life threatening events. Early warning scores (EWS), like the Modified Early Warning Score (MEWS), assist care givers in assessing patients' clinical situation, but cannot alert for deterioration between measurements. New devices, like the ViSi Mobile (VM) and HealthPatch (HP) allow for continuous monitoring and can alert deterioration in an earlier phase. VM and HP were tested regarding MEWS calculation compared to nurse measurements, and detection of high MEWS in periods between nurse observations. ⋯ Both VM and HP are promising for continuous vital sign monitoring and may be more accurate than nurses. High MEWS can be detected in hospitalized patients around the clock and clinical deterioration at an earlier phase during unobserved periods.
-
Observational Study
Performance of clinical risk scores to predict mortality and neurological outcome in cardiac arrest patients.
Several scores are available to predict mortality and neurological outcome in cardiac arrest patients admitted to the intensive care unit (ICU). The aim of the study was to externally validate the prognostic value of four previously published risk scores. ⋯ This study confirms the good prognostic performance of cardiac arrest specific scores to predict mortality and neurological outcomes in cardiac arrest patients. Routine use of OHCA or CAHP score helps to objectively risk stratify these vulnerable patients and thereby may improve therapeutic decisions.
-
Randomized Controlled Trial
The Effect of Intravenous Adrenaline on Electrocardiographic Changes During Resuscitation in Patients with Initial Pulseless Electrical Activity in Out of Hospital Cardiac Arrest.
Presence of electrocardiographic rhythm in the absence of palpable pulses defines pulseless electrical activity (PEA) and the electrocardiogram (ECG) may provide a source of information during resuscitation. The aim of this study was to examine the development of ECG characteristics during advanced life support (ALS) from Out-of-hospital cardiac arrest (OHCA) with initial PEA, and to explore the potential effects of adrenaline on these characteristics. ⋯ ECG changes during ALS in cardiac arrest were associated with prognosis, and the administration of adrenaline impacted on these changes.