Resuscitation
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Out-of-hospital cardiac arrest (OHCA) at home is associated with lower rates of shockable initial rhythm and survival than OHCA in a public location. We determined whether medical history and medication use explain the association between OHCA location and presence of shockable initial rhythm and survival rate. ⋯ Comorbidity and medication use do not substantially contribute in explaining the poor outcome from out-of-hospital cardiac arrest occurring at home. Even when adjusted for medical history, medication use, resuscitation characteristics, and demographics, a large gap of unexplained variance in shockable initial rhythm and survival remains.
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To establish incidence, phenotype, long-term functional outcome, and early EEG predictors of delirium after cardiac arrest. ⋯ Delirium is common after cardiac arrest, and probably leads to longer hospitalization and poorer outcome. Optimal treatment is unclear. Early EEG holds potential to identify patients at risk.
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Health-related quality of life (HRQoL) has been reported for out-hospital (OHCA) and in-hospital cardiac arrest (IHCA) separately, but potential differences between the two groups are unknown. The aim of this study is therefore to describe and compare HRQoL in patients surviving OHCA and IHCA. ⋯ Survivors of IHCA reported significantly worse HRQoL compared to survivors of OHCA. Consequently, research data gathered from one of these populations may not be generalizable to the other.
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To determine if mathematical optimization of in-hospital defibrillator placements can reduce in-hospital cardiac arrest-to-defibrillator distance compared to existing defibrillators in a single hospital. ⋯ Optimization-guided placement of in-hospital defibrillators can reduce the distance from an IHCA to the closest defibrillator. Equivalently, optimization can match existing defibrillator performance using far fewer defibrillators.
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Extracorporeal life support (ECLS) has shown promise in the management of cardiac arrest. The purpose of this study was to examine temporal trends and predictors of ECLS utilization and survival to discharge among inpatients with cardiac arrest in the United States. ⋯ Mortality after cardiac arrest for those on ECLS has substantially decreased. Younger age, shockable rhythm, and out-of-hospital arrest location were predictive of survival or utilization. As ECLS use increases, it is critical to define selection criteria that maximize the benefits of ECLS.