Resuscitation
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Multicenter Study Observational Study
Complete versus culprit-lesion-only percutaneous coronary intervention after out-of-hospital cardiac arrest in patients with multivessel disease.
Multivessel coronary artery disease (MVD) represents a common finding at invasive coronary angiography (ICA) among out-of-hospital cardiac arrest (OHCA) survivors. However, optimal invasive treatment strategy for MVD in OHCA remains unknown. Our study aims to assess if complete revascularization improves one-year clinical outcomes in these patients. ⋯ Our findings suggest that a complete percutaneous coronary revascularization strategy is associated with improved one-year survival rates in patients with MVD resuscitated from OHCA.
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Limited evidence supports guidelines to perform chest compressions at the lower half of the sternum. Imaging studies suggest this location may obstruct blood flow. Our primary aim was to compare the highest arterial line systolic blood pressure (SBP) during lower-half-of-sternum chest compressions (CC) versus those left-of-sternum, where the left ventricle is more likely located. Secondarily, we compared the highest end-tidal CO2 (ETCO2). ⋯ In our pilot, retrospective, observational study of select ED cardiac arrest patients, left-of-sternum chest compressions are associated with higher SBP than lower-half-of-sternum compressions, while ETCO2 was similar.
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Randomized Controlled Trial
Optimum oxygen concentration for initiation of delivery room stabilization in preterm neonates: A Randomized Controlled Trial.
The ideal choice of initial fraction of inspired oxygen (FiO2) to stabilize preterm neonates in the delivery room (DR) is not well-established. ⋯ A significantly higher number of preterm neonates < 34 weeks' gestation requiring DR stabilization achieved a 5-minute SpO2 of ≥ 80 % with higher minute-specific SpO2 trends when stabilized with an initial FiO2 of 60 % compared to 30 %.
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Observational Study
Visual detection of pulselessness by carotid artery sonography - A prospective observational study among medical students.
This cross-sectional study aimed to determine whether medical students with little to no ultrasound experience could correctly distinguish between 'pulsation present' and 'no pulsation present' after a short introductory video on the subject using ultrasound videos of the common carotid artery (CCA). ⋯ Medical students seem to be able to detect the absence of a pulse with a high degree of accuracy using 2D ultrasound of the CCA in a controlled study setting, using different ultrasound modes. The results of this study suggest that a combination of Color Doppler and B-mode may be useful when evaluating the CCA during CPR to answer the question 'pulsation present' or 'no pulsation present'.
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Randomized Controlled Trial
Selective or routine face mask application for breathing support of preterm infants at birth: a randomised trial.
Most preterm infants breathe spontaneously at birth. Despite this, the majority have a face mask immediately applied for breathing support. Face mask application may inhibit spontaneous breathing in newborn infants. We wished to determine whether selectively applying a mask to give positive pressure ventilation (PPV) for apnoea or bradycardia only compared to routinely applying a mask for continuous positive airway pressure (CPAP) resulted in fewer preterm infants receiving PPV in the delivery room (DR). ⋯ Selectively applying a face mask for PPV only did not result in fewer preterm infants receiving PPV in the DR.