Resuscitation
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Editorial Letter
Prognostication of the ECMO brain: Comparable yet different.
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Multicenter Study
Prognostic Performance of Gray-White Matter Ratio in Adult Out-of-Hospital Cardiac Arrest Patients after Receiving Extracorporeal Cardiopulmonary Resuscitation.
Gray-to-white matter ratio (GWR), measured by computed tomography (CT), is commonly used to predict poor neurological outcomes after out-of-hospital cardiac arrest (OHCA). The prognostic performance of GWR in OHCA patients receiving extracorporeal cardiopulmonary resuscitation (ECPR) is not known. ⋯ Early neuro-prognostication depending on GWR may not be sufficient after ECPR and requires a multimodal approach.
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Multicenter Study
Long term functioning with poor neurologic outcome after cardiac arrest.
Around six percent of comatose patients after cardiac arrest have a Cerebral Performance Categories score of three (CPC3) at six months after the arrest, classified as severe neurological disability. There is limited knowledge regarding the likelihood of further recovery in the cognitive, emotional, and quality of life domains. We aimed to estimate the probability of recovery towards independency. ⋯ Our study shows that while the probability of recovery towards independence for patients with severe neurological disability at six months after cardiac arrest is limited, most long-term survivors are satisfied with their quality of life.
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Multicenter Study Observational Study
Early point-of-care echocardiography as a predictive factor for absence of return of spontaneous circulatory in out-of-hospital cardiac arrests: a multicentre observational study.
Early assessment of the prognosis of a patient in cardiac arrest during cardiopulmonary resuscitation is highly challenging. This study aims to evaluate the predictive outcome value of early point-of-care ultrasound (POCUS) in out-of-hospital settings. ⋯ Early POCUS cardiac standstill during CPR for out-of-hospital cardiac arrest was a reliable predictor of the absence of ROSC. However, its presence alone was not sufficient to determine the termination of resuscitation efforts.
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Randomized Controlled Trial
The Time-Dependent Yield of Standard vs. Invasive Resuscitation Strategies: A Secondary Analysis of the Prague Out-of-Hospital Cardiac Arrest Study.
It is unclear how invasive resuscitative protocols may impact the time-dependent prognosis of out-of-hospital cardiac arrest (OHCA) resuscitations, or the relationship between intra-arrest transport and outcomes. ⋯ In comparison to standard resuscitation, invasive strategy cases had fewer achieve sustained ROSC, however improved overall 30-day favourable neurological outcomes. While standard resuscitation yield was limited to < 60 min, invasive protocols offer a second extended window of potential successful resuscitation.