Journal of the American Heart Association
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Multicenter Study Comparative Study
Hospital variation in survival after in-hospital cardiac arrest.
In-hospital cardiac arrest (IHCA) is common and often fatal. However, the extent to which hospitals vary in survival outcomes and the degree to which this variation is explained by patient and hospital factors is unknown. ⋯ Significant variability in IHCA survival exists across hospitals, and this variation persists despite adjustment for measured patient factors and within hospital subgroups. These findings suggest that other hospital factors may account for the observed site-level variations in IHCA survival.
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Comparative Study
Efficacy of chest compressions directed by end-tidal CO2 feedback in a pediatric resuscitation model of basic life support.
End-tidal carbon dioxide (ETCO2) correlates with systemic blood flow and resuscitation rate during cardiopulmonary resuscitation (CPR) and may potentially direct chest compression performance. We compared ETCO2-directed chest compressions with chest compressions optimized to pediatric basic life support guidelines in an infant swine model to determine the effect on rate of return of spontaneous circulation (ROSC). ⋯ The use of ETCO2-directed chest compressions is a novel guided approach to resuscitation that can be as effective as standard CPR optimized with marker, video, and verbal feedback.
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Pulmonary hypertension (PH) in patients with heart failure (HF) is associated with worse outcomes and is rapidly being recognized as a therapeutic target. To facilitate pragmatic research efforts, data regarding the prognostic importance of noninvasively assessed pulmonary artery systolic pressure (PASP) in stable ambulatory patients with HF are needed. ⋯ Elevated PASP, determined by echocardiography, identifies ambulatory patients with HF at increased risk for adverse events.
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Multicenter Study Observational Study
Bedside tool for predicting the risk of postoperative atrial fibrillation after cardiac surgery: the POAF score.
Atrial fibrillation (AF) remains the most common complication after cardiac surgery. The present study aim was to derive an effective bedside tool to predict postoperative AF and its related complications. ⋯ The POAF score is a simple, accurate bedside tool to predict postoperative AF and its related or accompanying complications.