Resuscitation
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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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Observational Study
Prognostic impact of the conversion to a shockable rhythm from a non-shockable rhythm for patients suffering from out-of-hospital cardiac arrest.
For patients suffering from an out-of-hospital cardiac arrest (OHCA), having an initial shockable rhythm is a marker of good prognosis. It has been suggested as one of the main prognosticating factors for the selection of patients for extracorporeal resuscitation (E-CPR). However, the prognostic implication of converting from a non-shockable to a shockable rhythm, as compared to having an initial shockable rhythm, remains uncertain, especially among patients that can otherwise be considered eligible for E-CPR. The objective of this study was to evaluate the association between the initial rhythm and its subsequent conversion and survival following an OHCA, for the general population and for E-CPR candidates. ⋯ The initial rhythm remains a much better prognostic marker than subsequent rhythms for all patients suffering from an OHCA, including in the subset of potential E-CPR candidates.
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An investigation of inter-shock timing and electrode placement for double-sequential defibrillation.
Double-Sequential Defibrillation (DSD) is the near-simultaneous use of two defibrillators to treat refractory VF. We hypothesized that (1) risk of DSD-associated defibrillator damage depends on shock vector and (2) the efficacy of DSD depends on inter-shock time. ⋯ University of Alabama at Birmingham Institutional Animal Care and Use Committee (IACUC) Protocol Number 06860.
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Paediatric traumatic out-of-hospital cardiac arrest (OHCA) is a rare event with few survivors. We examined long-term trends in the incidence and outcomes of paediatric traumatic OHCA and explored the frequency and timing of intra-arrest interventions. ⋯ The incidence and outcomes of paediatric traumatic OHCA remained unchanged over an 18 year period. Early correction of reversible causes by reducing delays to the delivery of trauma-specific interventions may yield additional survivors.
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The incidence of cardiac arrest (CA) in nursing homes is rising. Our objective was to compare nursing home CAs with at-home CAs in patients aged 65 and over with regard to the CAs' characteristics, the use and characteristics of cardiopulmonary resuscitation (CPR), and the outcome. ⋯ Nursing home residents who experience a CA are less likely to receive CPR from a MICU. If CPR is performed, however, the residents' prognosis is no worse than that of patients treated at home.