Resuscitation
-
Extracorporeal cardiopulmonary resuscitation (ECPR) is a treatment for refractory out-of-hospital cardiac arrest (OHCA), often due to acute coronary syndrome (ACS). However, the long-term impact of prehospital ECPR on heart function in surviving patients remains unclear. ⋯ Most patients who were treated with prehospital ECPR for refractory OHCA due to ACS and survived with good neurological outcomes recovered a good heart function at one year, and half of them were working.
-
Elevated jugular bulb venous oxygen saturation (SjvO2) after cardiac arrest may be due to diffusion-limited oxygen extraction secondary to perivascular edema. Treatment with hyperosmolar solution (HTS) may decrease this edema and thus the barrier to oxygen diffusion. Alternatively, SjvO2 may rise when cerebral metabolic rate declines due to irreversible cellular injury, which would not be affected by HTS. Electroencephalography (EEG) may differentiate between these etiologies of elevated SjvO2. We hypothesized SjvO2 would be lower after treatment with HTS and EEG could identify treatment responders. ⋯ HTS was independently associated with decreased SjvO2 in patients resuscitated from cardiac arrest, and this effect was limited to patients with benign pretreatment EEG patterns. Our results suggest diffusion-limited oxygen extraction secondary to modifiable perivascular edema as the etiology of elevated SjvO2, and EEG pattern may be useful to identify treatment responders.
-
Randomized Controlled Trial Multicenter Study
Low physical activity level in out-of-hospital cardiac arrest survivors with obesity, mobility problems and cognitive impairment: Results from the TTM2 trial.
-
To assess the accuracy and reliability of GPT-4o for scoring examinees' performance on cardiopulmonary resuscitation (CPR) skills tests. ⋯ GPT-4o demonstrated a level of accuracy that was similar to that of senior experts in examining CPR skills examination videos. The results demonstrate the potential for deploying this large language model in medical examination settings.
-
Across the world, many systems have implemented extracorporeal cardiopulmonary resuscitation (ECPR) as a potential treatment strategy for patients in refractory cardiac arrest. To date, there are no universally accepted criteria for patient selection for ECPR. We conducted a systematic review to explore the variability in patient eligibility criteria for ECPR across systems. ⋯ PROSPERO (CRD42023451109).