Resuscitation
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Multicenter Study Observational Study
Does endotracheal intubation increases chest compression fraction in out of hospital cardiac arrest: A substudy of the CAAM trial.
Optimal out of hospital cardiac arrest (OHCA) airway management strategies remain unclear. We compared chest compression fraction (CCF) between patients receiving endotracheal intubation (ETI) versus bag mask ventilation (BMV). ⋯ In our substudy whole intervention CCF among OHCA was not modified by ETI compared to BMV. In the ETI group we observed lower NFT associated with ventilations and higher NFT associated with mechanical chest compression devices placement. CCF was lower in the ETI group during the first cycle.
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Multicenter Study Observational Study
Differences in durations, adverse events, and outcomes of in-hospital cardiopulmonary resuscitation between day-time and night-time: An observational cohort study.
After out-of-hospital cardiac arrest patients experience differences in duration of CPR, chest injury, return of circulation and survival, depending on time of day.
pearl -
Multicenter Study
Bystander automated external defibrillator application in non-shockable out-of-hospital cardiac arrest.
An increasing proportion of patients with OHCA present with non-shockable rhythms, among whom the benefit from AED application is not known. ⋯ The application of an AED in non-shockable public witnessed OHCA was associated with a higher frequency of bystander CPR. The probabilities of pre-hospital ROSC, pulse at ED arrival, and survival to hospital discharge were not altered by the application of an AED.
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Prognostic tools typically combine several time-invariant clinical predictors using regression models that yield a single, time-invariant outcome prediction. This results in considerable information loss as repeatedly or continuously sampled data are aggregated into single summary measures. We describe a method for real-time multivariate outcome prediction that accommodates both longitudinal data and time-invariant clinical characteristics. ⋯ We describe a novel methodology for combining GBTM output and clinical covariates to estimate patient-specific prognosis over time. Refinement of such methods should form the basis for new avenues of prognostication research that minimize loss of clinically important information.
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Observational Study
Impact of right ventricular dysfunction on mortality in adults with cardiac arrest undergoing coronary angiogram.
We sought to identify the impact of echocardiographic right ventricular (RV) systolic dysfunction on mortality in adults with cardiac arrest (CA). ⋯ In this observational contemporary study, RV dysfunction was independently associated with higher mortality in adults with CA undergoing coronary angiogram. RV dysfunction may be useful for risk stratification and management in this high-mortality population.