Resuscitation
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Observational Study
Contributing Factors to Early Recurrence of Ventricular Fibrillation during Out-of-hospital Cardiac Arrest: an Observational Retrospective Study.
In out-of-hospital cardiac arrest (OHCA), external electric shock (EES) is recommended for treating ventricular fibrillation (VF). Refibrillation commonly occurs within one minute post-shock. We aimed to investigate refibrillation times and identifyclinical and electrical factors associated with them. ⋯ In non-traumatic OHCA, most refibrillations occurred within 45-s post-shock. Age and post-shock hands-off time were the two contributing factors to time to refibrillation.
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We evaluated the effect of chest compression fraction (CCF) on survival to hospital discharge and return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) patients with non-shockable rhythms. ⋯ We observed an incremental benefit from higher CCF on the incidence of ROSC, but not survival, among non-shockable OHCA patients with CCF higher than 40%.
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Multicenter Study
The Association between Post-Cardiac Arrest Cerebral Oxygenation and Survival with Favorable Neurological Outcomes: A Multicenter Study.
Cerebral oximetry is a non-invasive system that uses near infrared spectroscopy to measure regional cerebral oxygenation (rSO2) in the frontal lobe of the brain. Post-cardiac arrest rSO2 may be associated with survival and neurological outcomes in out-of-hospital cardiac arrest patients; however, no studies have examined relationships between rSO2 and neurological outcomes following in-hospital cardiac arrest (IHCA). We tested the hypothesis that rSO2 following IHCA is associated with survival and favorable neurological outcomes. ⋯ There may be a significant physiological difference in rSO2 in the first two hours after ROSC in IHCA patients who achieve favorable neurological outcomes, however, this difference may not be clinically significant.
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Survival following out-of-hospital cardiac arrest (OHCA) decreases as the interval from collapse to CPR and defibrillation increases. Innovative approaches are needed to reduce response intervals, especially for private locations. ⋯ In this initial US-based experience of a smartphone program for suspected OHCA in private and public locations, Verified Responders reported a positive experience, though were only involved in a small fraction of OHCA. Studies should determine how this type of program could be enhanced to involve more OHCA events.
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Randomized Controlled Trial
Early-onset pneumonia following bag-mask ventilation versus endotracheal intubation during cardiopulmonary resuscitation: A substudy of the CAAM trial.
Early-onset pneumonia (EOP) is a common in-hospital complication in survivors of out-of-hospital cardiac arrest. In this substudy of the CAAM trial, we aimed to compare whether bag mask ventilation (BMV) compared to endotracheal intubation (ETI) performed during cardiopulmonary resuscitation increases the risk of developing EOP. ⋯ In this substudy of the CAAM trial, development of early-onset pneumonia in out-of-hospital cardiac arrest survivors did not depend on airway management technique during CPR.