Resuscitation
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Randomized Controlled Trial
Modified volumetric capnography-derived parameter: A potentially stable indicator in monitoring cardiopulmonary resuscitation efficacy in a porcine model.
We aimed to investigate whether the ability of the volumetric capnography-derived parameter, the volume of CO2 eliminated per minute and per kg body weight (V'CO2 kg-1), in monitoring the quality of CPR and predicting the return of spontaneous circulation (ROSC) remains undisturbed by hyperventilation. ⋯ V'CO2 kg-1 performs better than PETCO2 in monitoring the quality of CPR during hyperventilation. In predicting ROSC during variations in a ventilation state, V'CO2 kg-1 has good predictive ability.
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For out-of-hospital cardiac arrest (OHCA) in residential areas, a dispatcher driven alert-system using text messages (TM-system) directing local rescuers (TM-responders) to OHCA patients was implemented and the desired density of automated external defibrillators (AEDs) or TM-responders investigated. ⋯ With increasing AED and TM-responder density within a TM-system, time to defibrillation in residential areas decreased. AED and TM-responders only competed with ambulances, not with first responders. The recommended density of AEDs and TM-responders for earliest defibrillation is 2 AEDs/km2 and >10 TM-responders/km2.
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ECG-monitoring is a strong predictor for 30-days survival after in-hospital cardiac arrest (IHCA). The aim of the study is to investigate factors influencing the effect of ECG-monitoring on 30-days survival after IHCA and elements of importance in everyday clinical practice regarding whether patients are ECG-monitored prior to IHCA. ⋯ ECG-monitoring in IHCA was associated to a 38% lower adjusted mortality, despite this finding only every other IHCA patient was monitored. The significant variability in the frequency of ECG-monitoring in IHCA at different centres needs to be evaluated in future research. Guidelines for in-hospital ECG-monitoring could contribute to an improved identification and treatment of patients at risk, and possibly to an improved survival.