Resuscitation
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Randomized Controlled Trial
The effective group size for teaching cardiopulmonary resuscitation skills - a randomized controlled simulation trial.
The ideal group size for effective teaching of cardiopulmonary resuscitation is currently under debate. The upper limit is reached when instructors are unable to correct participants' errors during skills practice. This simulation study aimed to define this limit during cardiopulmonary resuscitation teaching. ⋯ This randomized controlled simulation trial reveals decreased ability of instructors to detect Basic Life Support performance errors with increased group size. The maximum group size enabling Basic Life Support instructors to correct more than 80% of errors is six. We therefore recommend a maximum instructor-to-participant ratio of 1:6 for cardiopulmonary resuscitation courses.
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Randomized Controlled Trial Multicenter Study
Younger age is associated with higher levels of self-reported affective and cognitive sequelae six months post-cardiac arrest.
Affective and cognitive sequelae are frequently reported in cardiac arrest survivors; however, little is known about the risk factors. We assessed the hypothesis that self-reported affective and cognitive sequelae six months after OHCA may be associated with demography, acute care and cerebral outcome. ⋯ Younger age was associated with higher levels of self-reported affective and cognitive sequelae six months post OHCA. Female gender may be associated with self-reported anxiety. A higher CPC score may be a proxy for self-reported affective sequelae.
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Randomized Controlled Trial Multicenter Study
The effect of immediate coronary angiography after cardiac arrest without ST-segment elevation on left ventricular function. A sub-study of the COACT randomised trial.
The effect of immediate coronary angiography and percutaneous coronary intervention (PCI) in patients who are successfully resuscitated after cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) on left ventricular function is currently unknown. ⋯ Netherlands Trial Register number, NTR4973.
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Randomized Controlled Trial
Glycopyrrolate does not ameliorate hypothermia associated bradycardia in healthy individuals: A randomized crossover trial.
Hypothermia improves outcomes following ischemia-reperfusion injury. Shivering is common and can be mediated by agents such as dexmedetomidine. The combination of dexmedetomidine and hypothermia results in bradycardia. We hypothesized that glycopyrrolate would prevent bradycardia during dexmedetomidine-mediated hypothermia. ⋯ Glycopyrrolate did not prevent the bradycardic response to hypothermia and dexmedetomidine. Mean arterial blood pressure was higher in subjects receiving a bolus of glycopyrrolate before induction of hypothermia. Bolus glycopyrrolate was associated with less intense thermal sensation and less discomfort during cooling.
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Randomized Controlled Trial
Biomarker prognostication of cognitive impairment may be feasible even in out-of hospital cardical arrest survivors with good neurological outcome.
Patients surviving out-of hospital cardicac arrest, with good neurological outcome according to Cerebral Performance Category, frequently have neuropsychological impairment. We studied whether biomarker data (S-100b and neuron-specific enolase) obtained during the ICU stay predicted cognitive impairment 6 months after resuscitation. ⋯ Early biomarker prognostication of cognitive impairment is feasible even in OHCA survivors with good neurological outcome as defined by CPC. NSE at 48 h predicted cognitive impairment.