Resuscitation
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We aimed to use a high-fidelity computational model that captures key interactions between the cardiovascular and pulmonary systems to investigate whether current CPR protocols could potentially be improved. ⋯ Our results indicate that current CPR protocols could potentially be improved. Excessive ventilation could be detrimental to organ oxygenation during CPR, due to the negative haemodynamic effect of increased pulmonary vascular resistance. Particular attention should be given to the chest compression force to achieve satisfactory CO. Future clinical trials aimed at developing improved CPR protocols should explicitly consider interactions between chest compression and ventilation parameters.
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To investigate transient and persistent effects of the Shanghai Omicron epidemic in 2022 on the incidence, characteristics, and outcomes of out-of-hospital cardiac arrest (OHCA). ⋯ The monthly number of OHCAs doubled during the Omicron epidemic in Shanghai, and it remained elevated for another two months. OHCA affected individuals with cardiovascular and cerebrovascular diseases more during and after the epidemic than before it.
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There are limited data on the relationship of ST-segment-elevation myocardial infarction (STEMI) management strategy and in-hospital cardiac arrest (IHCA). ⋯ Early PCI in STEMI impacts the natural history of IHCA including timing and type of IHCA.
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Multiple randomized clinical trials have compared specific airway management strategies during ACLS with conflicting results. However, patients with refractory cardiac arrest died in almost all cases without the availability of extracorporeal cardiopulmonary resuscitation (ECPR). Our aim was to determine if endotracheal intubation (ETI) was associated with improved outcomes compared to supraglottic airways (SGA) in patients with refractory cardiac arrest presenting for ECPR. ⋯ ETI was associated with improved oxygenation and ventilation after prolonged CPR. This resulted in increased rate of candidacy for ECPR and increased neurologically favorable survival to discharge with ETI compared to SGA.
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Editorial Comment
Anti-seizure medicine treatment of post-anoxic myoclonus.