Resuscitation
-
Multicenter Study Observational Study
The CAHP (Cardiac Arrest Hospital Prognosis) score: A tool for risk stratification after out-of-hospital cardiac arrest in elderly patients.
Older age is associated with worse outcome after out-of-hospital cardiac arrest (OHCA). Therefore, we tested the performance of CAHP score, to predict neurological outcome in elderly OHCA patients and to select patients most likely to benefit from coronary angiogram (CAG). ⋯ The CAHP score exhibited a good discrimination performance to predict neurological outcome in elderly OHCA patients. This score could represent a helpful tool for treatment allocation. A simple prognostication score could permit avoiding unnecessary procedures in patients with minimal chances of survival.
-
Observational Study
The association between duration of mechanical ventilation and survival in post cardiac arrest patients.
To assess the association between the duration of mechanical ventilation during post resuscitation care and 30-day survival after cardiac arrest. ⋯ A tendency for longer duration of post resuscitation care in the ICU was associated with higher 30-day survival in comatose patients admitted to intensive care after cardiac arrest.
-
Observational Study
Serum Tau as a predictor for neurological outcome after cardiopulmonary resuscitation.
We evaluated serum tau protein as biomarker for poor neurological outcome over an extended observation period in patients after successful cardiopulmonary resuscitation (CPR) treated with mild therapeutic hypothermia (MTH) or normothermia (NT). ⋯ Serum tau showed highest values and the best prognostic discrimination of poor neurological outcome at 72-96 h after CPR. Prolonged elevation may indicate ongoing axonal damage in patients with hypoxic encephalopathy.
-
Predicting outcome after cardiac arrest is challenging. We previously tested group-based trajectory modeling (GBTM) for prognostication based on baseline characteristics and quantitative electroencephalographic (EEG) trajectories. Here, we describe implementation of this method in a freely available software package and test its performance against alternative options. ⋯ We explored fundamentally different tools for patient-level predictions based on longitudinal and time-invariant patient data. Of the evaluated methods, GBTM resulted in optimal sensitivity while maintaining a false positive rate <1%. The provided code and software of this method provides an easy-to-use implementation for outcome prediction based on GBTMs.
-
Infectious complications frequently occur in intensive care unit patients admitted after out-of-hospital cardiac arrest. There is debate on the effects of temperature management on the incidence of infections, as well as on the efficacy and choice of antibiotic prophylaxis. In this substudy of the targeted temperature management (TTM) trial, we describe the microbiological profile of infectious complications in patients with cardiac arrest and examined the impact of TTM at 33 °C compared to TTM at 36 °C. Furthermore we aimed to determine the association between antibiotic prophylaxis and the incidence of infections. ⋯ Gram-negative pathogens are the most common causes of nosocomial infections following cardiac arrest. TTM does not impact the microbiological profile. It remains unclear whether patients in ICUs using antibiotic prophylaxis have a reduced risk of pneumonia and bacteremia that is unrelated to center effects.