Resuscitation
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Observational Study
Title: Electrical rhythm degeneration in adults with out-of-hospital cardiac arrest according to the no-flow and bystander low-flow time.
For out-of-hospital cardiac arrest (OHCA) patients, the influence of the delay before the initiation of resuscitation, termed the no-flow time (NFT), and duration of bystander-only resuscitation low-flow time (BLFT) on the type of electrical rhythm observed has not been well described. The objective of this study is to determine the relationship between NFT, BLFT and the likelihood of a shockable rhythm over time. ⋯ In this large observational study, we were able to demonstrate that longer NFT were associated with lower odds of shockable presenting rhythms. Bystander CPR significantly mitigates the degradation of shockable rhythms over time, strengthening the need to improve bystander CPR rates around the world.
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Measuring tidal volumes (TV) during bag-valve ventilation is challenging in the clinical setting. The ventilation waveform amplitude of the transthoracic impedance (TTI-amplitude) correlates well with TV for an individual, but poorer between patients. We hypothesized that TV to TTI-amplitude relations could be improved when adjusted for morphometric variables like body mass index (BMI), gender or age, and that TTI-amplitude cut-offs for ventilations with adequate TV (>400ml) could be established. ⋯ TTI-amplitude to TV relations were established and cut-offs for ventilations with adequate TV determined. Patient morphometric variables related to gender, age and BMI explain part of the variability in the measurements.
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We aimed to characterize extracorporeal CPR (ECPR) outcomes in our center and to model prediction of severe functional impairment or death at discharge. ⋯ Mortality and functional impairment following ECPR in children remain high. It is possible to model severe functional impairment or death at discharge with high accuracy using daily post-ECPR data up to 28 days. This represents a prognostically valuable tool and may identify endpoints for future interventional trials.
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To estimate the annual and lifetime economic productivity loss due to adult out-of-hospital cardiac arrest (OHCA) in the United States (U.S.). ⋯ Adult non-traumatic OHCA events are associated with significant annual and lifetime economic productivity losses and should be the focus of public health resources to improve preventative measures and survival outcomes.
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Observational Study
Cerebral Perfusion and Metabolism with Mean Arterial Pressure 90 vs. 60 mmHg in a Porcine Post Cardiac Arrest Model with and without Targeted Temperature Management.
To determine whether targeting a mean arterial pressure of 90 mmHg (MAP90) would yield improved cerebral blood flow and less ischaemia compared to MAP 60 mmHg (MAP60) with and without targeted temperature management at 33 °C (TTM33) in a porcine post-cardiac arrest model. ⋯ FOTS, id 8442.