Resuscitation
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Review Meta Analysis
Paediatric traumatic out-of-hospital cardiac arrest: A systematic review and meta-analysis.
In this study, we sought to quantitatively describe the survival outcomes, incidence rates, and predictors of survival after paediatric traumatic out-of-hospital cardiac arrest (OHCA). ⋯ Survival outcomes of paediatric traumatic OHCA are poor and existing studies report varying incidence rates. The absence of large prospective and international registry data hinders the development of novel strategies to improve survival rates.
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Review Meta Analysis
Tracheal suctioning of meconium at birth for non-vigorous infants: A systematic review and meta-analysis.
The International Liaison Committee on Resuscitation sought to review the initial management of non-vigorous newborns delivered through meconium stained amniotic fluid (MSAF). ⋯ PROSPERO; CRD42019122778.
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Review
Intravenous vs. Intraosseous Administration of Drugs During Cardiac Arrest: A Systematic Review.
To perform a systematic review of the literature on intravenous (IV) vs. intraosseous (IO) administration of drugs during cardiac arrest in order to inform an update of international guidelines. ⋯ We identified a limited number of studies comparing IV vs. IO administration of drugs during cardiac arrest. Pooled results from four observational studies favoured IV access with very low certainty of evidence. From the subgroup analyses of two randomized clinical trials, there was no statistically significant interaction between the route of access and study drug on outcomes.
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Multicenter Study
Association between mild hypercapnia and hospital mortality in patients admitted to the intensive care unit after cardiac arrest: A retrospective study.
Mild hypercapnia may increase cerebral oxygenation and attenuate cerebral injury in post-cardiac arrest patients. However, its association with hospital mortality has not been evaluated. ⋯ PaCO2 has a U-shaped association with odds ratio for hospital mortality, with mild hypercapnia not having a higher hospital survival probability than normocapnia in post-cardiac arrest patients.
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Adrenaline is an important component in the resuscitation of individuals experiencing out-of-hospital cardiac arrest (OHCA). The 2018 Advanced Cardiac Life Support (ACLS) algorithm gives the option of either intravenous (IV) or intraosseous (IO) routes for adrenaline administration during cardiac arrest. However, the optimal route during prehospital resuscitation remains controversial. This study aims to investigate whether IV and IO routes lead to different outcomes in OHCA patients who received prehospital adrenaline. ⋯ Compared with the IO approach, the IV approach appears to be the optimal route for adrenaline administration in advanced life support for OHCA during prehospital resuscitation.