Resuscitation
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Randomized Controlled Trial Multicenter Study
Mechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm: a multi-centre feasibility randomised controlled trial (COMPRESS-RCT).
Mechanical chest compression devices deliver high-quality chest compressions. Early data suggests that mechanical devices may be superior to manual chest compressions in adults following an in-hospital cardiac arrest patients. To determine the feasibility of undertaking an effectiveness trial in this population, we undertook a feasibility randomised controlled trial. ⋯ COMPRESS-RCT identified important factors that preclude progression to an effectiveness trial of mechanical CPR in the hospital setting in the UK. Findings will inform the design of future in-hospital intra-arrest intervention trials. ISRCTN38139840, date of registration 9th January 2017.
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To assess whether any clinical decision rule for patients sustaining an in-hospital cardiac arrest (IHCA) can predict mortality or survival with poor neurological outcome. ⋯ We identified very low certainty evidence for one clinical decision rule (the UN-10 rule) that was unable to reliably predict mortality or survival with unfavorable neurological outcome for adults suffering from IHCA. We identified no evidence for children. PROSPERO CRD42020164091.
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Randomized Controlled Trial
The Effect of Airway Management on CPR Quality in the Paramedic2 Randomised Controlled Trial.
Good quality basic life support (BLS) is associated with improved outcome from cardiac arrest. Chest compression fraction (CCF) is a BLS quality indicator, which may be influenced by the type of airway used. We aimed to assess CCF according to the airway strategy in the PARAMEDIC2 study: no advanced airway, supraglottic airway (SGA), tracheal intubation, or a combination of the two. Our hypothesis was that tracheal intubation was associated with a decrease in the CCF compared with alternative airway management strategies. ⋯ There was no significant difference in the compression fraction associated with the airway management strategy.
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There is a lack of new promising therapies to improve the dismal outcomes from cardiac arrest. The objectives of this study were: (1) To identify novel pharmacological therapies investigated in experimental animal studies and (2) to identify pharmacological therapies translated from experimental animal studies to clinical trials. ⋯ Numerous different pharmacological interventions have been tested in experimental animal models. Despite this only a limited number of these interventions have advanced to clinical trials, however several of the clinical trials tested interventions that were first tested in experimental animal models.