Resuscitation
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Multicenter Study Observational Study
Performance of the ERC/ESICM-recommendations for neuroprognostication after cardiac arrest: insights from a prospective multicenter cohort.
To investigate the performance of the 2021 ERC/ESICM-recommended algorithm for predicting poor outcome after cardiac arrest (CA) and potential tools for predicting neurological recovery in patients with indeterminate outcome. ⋯ All comatose resuscitated patients who fulfilled the ERC-ESICM criteria for poor outcome after CA had poor outcome at three months, even if a self-fulfilling prophecy cannot be completely excluded. In patients with indeterminate outcome (half of the population), favourable signs predicted neurological recovery, reducing prognostic uncertainty.
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Multicenter Study Observational Study
EEG for good outcome prediction after cardiac arrest: a multicentre cohort study.
Assess the prognostic ability of a non-highly malignant and reactive EEG to predict good outcome after cardiac arrest (CA). ⋯ Nearly one-third of comatose patients resuscitated after CA had a non-highly malignant and reactive EEG that was associated with a good long-term outcome. Reactivity testing should be routinely performed since preserved EEG reactivity contributed to prognostic performance.
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Multicenter Study Comparative Study
Evaluating neurocognitive outcomes in out-of-hospital cardiac arrest survivors: a comparative study of performance-based and reported measures.
To (1) describe the prevalence of cognitive dysfunctions using performance-based and reported measures, and (2) explore the correlations between selected performance-based, patient-reported, and observer-reported neurocognitive outcome measures three months after hospital discharge in a population of out-of-hospital cardiac arrest (OHCA) survivors. ⋯ The results of this REVIVAL substudy suggest that although the performance-based and reported measures did not correlate, dual neurocognitive screening tools containing both a self-reported and an informant-reported version may have the potential to detect executive discrepancies in the return to everyday life and guide targeted neurorehabilitation after OHCA.
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Adherence to post-cardiac arrest care (PCAC) recommendations is associated with improved outcomes for adults. We aimed to describe the survival impact of meeting American Heart Association (AHA) PCAC guidelines in children after cardiac arrest. ⋯ In this retrospective multicenter registry study, absence of both post-cardiac arrest hypotension and fever were associated with increased odds of survival to hospital discharge. Further research is needed to understand the full impact of PCAC recommendation compliance on survival outcomes.
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Randomized Controlled Trial Multicenter Study
An economic evaluation of the Prioritising Responses Of Nurses To deteriorating patient Observations (PRONTO) clinical trial.
Early recognition and response to clinical deterioration reduce the frequency of in-hospital cardiac arrests, mortality, and unplanned intensive care unit (ICU) admissions. This study aimed to investigate the impact of the Prioritising Responses Of Nurses To deteriorating patient Observations (PRONTO) intervention on hospital costs and patient length of stay (LOS). ⋯ The results of the economic analysis demonstrated that the PRONTO intervention improved nurses' responses to patients with abnormal vital signs and significantly reduced hospital LOS by two days at 12 months in the intervention group compared to baseline. From the hospital's perspective, savings from reduced hospitalisations offset the costs of implementing PRONTO.