Resuscitation
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Multicenter Study Comparative Study
Regional variations in early and late survival after out-of-hospital cardiac arrest.
While prior studies highlight regional variations in out-of-hospital cardiac arrest (OHCA) survival, the underlying reasons remain unknown. We sought to characterize regional variations early and later survival to hospital discharge after OHCA. ⋯ In this prospective multicenter North American series, there were regional disparities in early and later survival after OHCA, suggesting that there are underlying regional differences in out-of-hospital and post-arrest care beyond traditional Utstein predictors. Community efforts to improve OHCA survival must address both out-of-hospital and in-hospital care.
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The aim of this study was to evaluate the risk of prolonged transportation against the benefit of treatment in high-volume centres for out-of-hospital cardiac arrest (OHCA) patients without prehospital return of spontaneous circulation (ROSC). ⋯ A higher rate of survival to discharge was demonstrated when OHCA patients without prehospital ROSC were transported to high-volume rather than low-volume centres. The rate was still significantly higher when the transportation time was longer compared with that of low-volume centres.
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Comparative Study
A comparison of survival with and without extracorporeal life support treatment for severe poisoning due to drug intoxication.
The use of extracorporeal life support (ECLS) as a treatment for severe cardiovascular impairment due to poisoning is unclear. Therefore, we conducted a retrospective cohort analysis to compare survival among critically ill poisoned patients treated with or without ECLS. ⋯ In the absence of response to conventional therapies, we consider that ECLS may improve survival in critically ill poisoned patients experiencing cardiac arrest and severe shock.
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Comparative Study
Female sex is not associated with improved rates of ROSC or short term survival following prolonged porcine ventricular fibrillation.
There may be a survival benefit in female patients experiencing cardiac arrest, which could affect the interpretation of in vivo animal studies. We hypothesized that sex predicts return of spontaneous circulation (ROSC) and short-term survival (SURV) in porcine studies of prolonged ventricular fibrillation (VF). ⋯ Sex predicts neither ROSC nor SURV in a swine model of prolonged VF.
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Cardiopulmonary resuscitation (CPR) using extracorporeal life support (ECLS) system has been successfully used to support patients with in- and out-of-hospital cardiac arrest (IHCA, OHCA) when conventional measures have failed. The purpose of the current study is to report on our experience with extracorporeal CPR in non-postcardiotomy patients. ⋯ CPR using modern miniaturized ECLS systems should be established in the treatment of prolonged cardiac arrest and unsuccessful conventional CPR in selected patients. CPR with ECLS for OHCA has worse outcomes compared to IHCA. Duration of CPR was independent risk factor for mortality after extracorporeal CPR.