Resuscitation
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Multicenter Study Observational Study
Survival and neurological outcome with extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest caused by massive pulmonary embolism: A two center observational study.
Cardiac arrest (CA) due to pulmonary embolism (PE) is associated with low survival rates and poor neurological outcomes. We examined whether Extracorporeal Cardiopulmonary Resuscitation (ECPR) improves the outcomes of patients who suffer from CA due to massive PE. ⋯ ECPR seems a promising treatment for cardiac arrest patients due to (suspected) massive pulmonary embolism compared to conventional CPR, though outcomes remain poor.
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Observational Study
Platelet dysfunction after out of hospital cardiac arrest. Results from POHCAR: a prospective observational, cohort study.
Coagulation and platelet function following out of hospital cardiac arrest (OHCA) at admission to a UK cardiology centre were investigated prospectively in this observational feasibility study, and compared to that of patients receiving percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI). ⋯ OHCA patients demonstrated reduced thrombin receptor function at hospital admission but overall clot formation dynamics comparable to STEMI patients, indicating no gross coagulopathy post OHCA in our cohort. Hyperfibrinolysis was common both post OHCA and after STEMI. The results of this small feasibility study cannot draw clinical conclusions but will inform power calculations for future studies.
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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.
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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.
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Multicenter Study
Neuron-Specific-Enolase as a Predictor of the Neurologic Outcome after Cardiopulmonary Resuscitation in Patients on ECMO.
Neuron-specific-enolase (NSE) is frequently used to predict the neurologic outcome in persistently unconscious patients after cardiopulmonary resuscitation (CPR). However, its predictive value is unclear in the setting of veno-arterial extracorporeal membrane oxygenation therapy (ECMO). Aim of this project is to evaluate the predictive value of NSE in ECMO patients. ⋯ In post-CPR patients on ECMO, NSE can be used to assess the neurologic outcome. Importantly, specificity was highest if using serial NSE measurements. Further research using prospective datasets is needed to verify these findings.