Resuscitation
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Review Meta Analysis
Effectiveness of digital resuscitation training in improving knowledge and skills: A systematic review and meta-analysis of randomised controlled trials.
This review aims to evaluate the effectiveness of digital resuscitation training in improving knowledge and skill compared with standard resuscitation training. ⋯ Despite the wide variation in digital resuscitation trainings, evidence suggesting the use of digital resuscitation training for improving knowledge and skills is inadequate. Well-designed non-inferiority RCTs in multiple settings with follow-up data and large sample size are needed to ensure the robustness of the evidence.
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To investigate the clinical course and early prognostic markers in cardiac arrest (CA) patients discharged from the intensive care unit (ICU) in an unresponsive wakefulness syndrome (UWS) or coma. ⋯ Neurological recovery was rare in CA patients discharged in UWS after prolonged ICU treatment. Status epilepticus requiring prolonged deep sedation is one potential reason for delayed awakening. Sensitivity for established poor outcome parameters to predict persistent UWS early after CA was moderate. SSEP, EEG and NSE may indicate absence of severe HIE early after CA.
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The Resuscitation Outcomes Consortium (ROC)epidemiological registry (Epistry) provides opportunities to assess trends in out-of-hospital cardiac arrest treatment and outcomes. ⋯ Survival from adult OHCA in multiple large geographically-separate sites improved over the study period. Marked site differences in survival persist and addressing this variation is essential to improve outcomes from OHCA across North America.
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In patients after cardiac arrest (CA), EEG reactivity (EEG-R) is proposed as a prognostic marker. However, no clear guidelines exist on how to test EEG-R and definitions are unspecific. Therefore, we aimed at forming international consensus regarding a stimulus protocol for EEG-R testing and the interpretation of EEG-R in daily clinical care. ⋯ This international consensus statement on EEG-R in patients after CA can be regarded as starting point. At the moment evidence is limited and our study can provide best-practice guidance in patients after CA as well as other comatose patients.