Resuscitation
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The prognostic implications of conversion to ventricular fibrillation (VF) in out-of-hospital cardiac arrest (OHCA) patients with an initial non-shockable rhythm are unclear. ⋯ Based on a large-scaled population-based cohort of OHCA, subsequent VF with defibrillation was associated with better outcomes among patients with an initial non-shockable rhythm.
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Norwegian 7th graders (12 years old) trained CPR using a 30 min DVD, an inflatable manikin and teachers as facilitators. They were instructed to take the kit home and expose as many family members and friends (adults) as possible to the training. We wanted to document the number of lay rescuers trained by this distribution model and CPR skills achieved. ⋯ The present model of CPR kit distribution via 7th graders enabled a significant percentage of the population to focus on CPR training. We believe the model secure discipline through the training program for first tier but not for second tier and speculate that 12-year-old children are too young to have an impact of adults commitment and motivation for training.
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Extracorporeal life support (ECLS) is associated with a high mortality rate in patients with preexisting multiple organ failure. To achieve better outcomes of ECLS in this high risk group, an understanding of the real impact of preexisting organ dysfunction on ECLS-associated mortality is necessary. ⋯ SOFA score is a practical assessment tool and is predictive of ECLS-associated mortality in non-postcardiotomy patients. Patients having cardiac arrest requiring CPR or acute renal failure requiring dialysis before ECLS may have inferior ECLS outcomes.
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Patients' outcomes after prolonged cardiac arrest are often grim. The aim of this study was to find the longest period of normovolemic, normothermic, cardiac arrest no-flow after which good neurologic outcome can be achieved with conventional therapies. ⋯ In our model, the limit of normovolemic, normothermic, cardiac arrest no-flow time, followed by ACLS, CPB, and prolonged mild hypothermia, seems to be 13 min.