Resuscitation
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Previous research suggests there may be differences in the effects of adrenaline related to the initial cardiac arrest rhythm. The aim of this study was to assess the effect of adrenaline compared with placebo according to whether the initial cardiac arrest rhythm was shockable or non-shockable. ⋯ Relative to placebo, the effects of adrenaline ROSC are greater for patients with an initially non-shockable rhythm than those with a shockable rhythms. Similar patterns are observed for longer term survival outcomes and favourable neurological outcomes, although the differences in effects are less pronounced. ISRCTN73485024.
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Randomized Controlled Trial
Using a smartwatch with real-time feedback improves the delivery of high-quality cardiopulmonary resuscitation by Healthcare Professionals.
Cardiopulmonary resuscitation (CPR) quality affects survival after cardiac arrest. We aimed to investigate if a smartwatch with real-time feedback can improve CPR quality by healthcare professionals. ⋯ Without real-time feedback, chest compressions tend to be too fast and too shallow. CPR quality can be improved with the assistance of a smartwatch providing real-time feedback.
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Observational Study
Adrenaline, ROSC and survival in patients resuscitated from in-hospital cardiac arrest.
To describe how administration of adrenaline is associated with return of spontaneous circulation (ROSC) and 30-day survival in patients with in-hospital cardiac arrest (IHCA). ⋯ In our cohort of 6033 patients retrieved from a national cardiopulmonary resuscitation registry, administration of adrenaline during resuscitation from IHCA was associated with a lower rate of ROSC and 30-day survival.
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Observational Study
Time course of platelet counts in relation to the neurologic outcome in patients undergoing targeted temperature management after cardiac arrest.
Thrombocytopenia is common and associated with mortality in critically ill patients. However, the time course of platelet counts and its association with the neurologic outcome after out-of-hospital cardiac arrest (OHCA) are not well known. The purpose of this study is to describe the time course of platelet counts in relation to the neurologic outcome in patients undergoing targeted temperature management (TTM) after CA. ⋯ The changes in platelet counts in OHCA patients have a biphasic pattern that is significantly different in patients with good neurologic outcomes and those with poor neurologic outcomes at 6 months. A low platelet count 7 days after CA was associated with a poor neurologic outcome and mortality at 6 months.
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Studies suggest that hyperoxemia increases short-term mortality after cardiopulmonary resuscitation (CPR), but the effect of hyperoxemia on long-term outcomes is unclear. We determined the prevalence of early hyperoxemia after CPR and its association with long-term neurological outcome and mortality. ⋯ We found no association between early post-arrest hyperoxemia and unfavourable outcome. Subgroup analysis found no differential effect depending on arrest location, initial rhythm or time-to-ROSC.