Resuscitation
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Editorial Letter
Prognostication of the ECMO brain: Comparable yet different.
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Regionalisation and organised pathways of care using specialist centre hospitals can improve outcomes for critically ill patients. Cardiac arrest centre hospitals (CAC) may optimise the delivery of post-resuscitation care. The International Liaison Committee on Resuscitation (ILCOR) has called for a review of the current evidence base. ⋯ This review supports a weak recommendation that adults with out-of-hospital cardiac arrest are cared for at CACs based on very low certainty of evidence. Randomised evidence has not confirmed the benefits of CACs found in observational studies, however this RCT was a single trial in a very specific setting and a population without ST elevation on post-ROSC ECG. The role of CACs in shockable and non-shockable subgroups, direct versus secondary transfer, as well as the impact of increased transport time and bypassing local hospitals remains unclear.
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Observational Study
Association between bystander automated external defibrillator use and survival in witnessed out-of-hospital cardiac arrest: A nationwide observational study in South Korea.
Sudden cardiac arrest is a global health issue, with out-of-hospital cardiac arrest (OHCA) posing a major challenge. Bystander cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) improve survival and neurological outcomes. However, their actual usage involves numerous constraints. Therefore, to determine the association between bystander AED use and survival of patients with OHCA, we analyzed South Korea's national OHCA database. ⋯ Survival to discharge or favorable neurological outcomes of patients with OHCA managed using bystander-applied AEDs and those without showed no significant difference. Factors such as AED accessibility and bystander preparedness influence the impact of bystander AED use. Further research should optimize AED deployment and usage strategies to enhance patient survival rate.