Resuscitation
-
Evaluate the trends in the incidence of in-hospital cardiopulmonary arrest (IHCA) and the associated mortality rate in children during 1997 to 2012. ⋯ The incidence of pediatric IHCA in the United States has increased from 1997 to 2012 while the mortality has decreased. The incidence of IHCA is higher among males, infants, black children, children from metropolitan regions and children from lower household income regions. The mortality after IHCA is higher among teenagers, black children, Hispanic children and children from metropolitan regions.
-
Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers in Singapore. ⋯ Barriers were present in 37% of cases. They were associated with lower proportion of CPR started and longer delay to CPR.
-
Observational Study
The association between timing of tracheal intubation and outcomes of adult in-hospital cardiac arrest: A retrospective cohort study.
Resuscitation guidelines indicate the ideal timing of tracheal intubation during in-hospital cardiac arrest (IHCA) has not been adequately studied. ⋯ Earlier tracheal intubation during cardiopulmonary resuscitation might be beneficial for clinical outcomes following IHCA. Intubation within 8.8min appears favourable for both neurological and survival outcomes. Nevertheless, this goal should be attempted by clinicians who experienced in intubation to avoid potential complications and harm.
-
Observational Study
Body Mass Index and Outcomes of In-hospital Ventricular Tachycardia and Ventricular Fibrillation Arrest.
Due to higher transthoracic impedance, obese patients may be less likely to be successfully defibrillated from ventricular tachycardia or ventricular fibrillation (VT/VF) arrest. However, the association between patient body mass index (BMI), defibrillation success, and survival outcomes of VT/VF arrest are poorly understood. ⋯ There was no significant difference in the likelihood of successful defibrillation with the first shock attempt among different BMI categories.
-
Reduction of pyruvate dehydrogenase (PDH) activity in the brain is associated with neurological deficits in animals resuscitated from cardiac arrest. Thiamine is an essential co-factor of PDH. The objective of this study was to examine whether administration of thiamine improves outcomes after cardiac arrest in mice. Secondarily, we aimed to characterize the impact of cardiac arrest on PDH activity in mice and humans. ⋯ The provision of thiamine after cardiac arrest improved neurological outcome and 10-day survival in mice. PDH activity was markedly depressed in post-cardiac arrest patients suggesting that this pathway may represent a therapeutic target.