Resuscitation
-
Conversion to shockable rhythm from an initial non-shockable rhythm is associated with good neurologic prognoses in patients with out-of-hospital cardiac arrest (OHCA). We aimed to investigate whether conversion to shockable rhythm has an association with good neurologic outcomes, according to the etiology of cardiac arrest. ⋯ Conversion to shockable rhythm had an association with good neurologic outcome in patients with OHCA with initial non-shockable rhythms, especially due to cardiac cause. However, rhythm conversion was not associated with better outcome in patients with non-medical causes.
-
Targeted temperature management (TTM) is a well-accepted neuro-protective intervention in the management of comatose survivors of cardiac arrest (CA). However, the impact of TTM on cardiac performance has not been adequately evaluated. ⋯ Mild hypothermia in CA survivors appears associated to positive changes in iHDs and cardiac performance, including a potential increase in cardiac contractility. Larger studies are needed to conclusively confirm these findings.
-
It is widely accepted that survival from OHCA may be improved through direct transfer of patients to hospitals with percutaneous coronary intervention (PCI) capability. However, within the New Zealand healthcare system there is limited evidence available to support this. We aimed to compare patient characteristics and outcomes following an out-of-hospital cardiac arrest between those patients transported to hospitals with or without PCI-capability within New Zealand. ⋯ Patient characteristic differences indicate that inequities in healthcare may exist in New Zealand related to age, ethnic group, and rurality. Thirty-day survival was significantly increased in patients conveyed directly to a hospital with PCI-capability.
-
To evaluate the predictive value of EEG reactivity assessment and confounders for neurological outcome after cardiac arrest. ⋯ After cardiac arrest, absence of EEG reactivity was predictive of unfavorable outcome. By contrast, a benign EEG was slightly predictive of a favorable outcome. Reactivity assessment may have important implications in the neuroprognostication process after cardiac arrest and could be influenced by sedation.
-
Maximum velocity during chest recoil has been proposed as a metric for chest compression quality during cardiopulmonary resuscitation (CPR). This study investigated the relationship of the maximum velocities during compression and recoil phases with compression depth and rate in manual CPR. ⋯ CV and RV were highly correlated with compression depth and compression and recoil times, respectively. Better understanding of the relationship between novel and current quality metrics could help with the interpretation of CPR quality studies.