Articles: out-of-hospital-cardiac-arrest.
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Randomized Controlled Trial Multicenter Study Pragmatic Clinical Trial
Bayesian Analysis of the Pragmatic Airway Resuscitation Trial.
Intubation and laryngeal tube insertion are common airway management strategies in out-of-hospital cardiac arrest. Bayesian analysis offers an alternate statistical approach to assess the results of a trial. We use Bayesian analysis to compare the effectiveness of initial laryngeal tube versus initial intubation strategies on outcomes after out-of-hospital cardiac arrest in the Pragmatic Airway Resuscitation Trial. ⋯ Under various prior assumptions, post hoc Bayesian analysis of the Pragmatic Airway Resuscitation Trial confirmed better out-of-hospital cardiac arrest outcomes with a strategy of initial laryngeal tube than initial intubation.
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Journal of critical care · Dec 2019
Multicenter Study Observational StudyAssociation between acute kidney injury and neurological outcome or death at 6 months in out-of-hospital cardiac arrest: A prospective, multicenter, observational cohort study.
This study aimed to evaluate the association between acute kidney injury (AKI) and 6 months neurological outcome after out-of-hospital cardiac arrest (OHCA). ⋯ AKI is associated with poor neurological outcome (MRS 4-6) at 6 months in OHCA patients treated with TTM.
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Multicenter Study Observational Study
Variation in survival after out-of-hospital cardiac arrest between receiving hospitals in Japan: an observational study.
Patient outcomes after out-of-hospital cardiac arrest (OHCA) varies at multilevel (geographical regions, emergency medical service agencies and receiving hospitals) in the USA. However, it remains unclear whether there is a variation in patient outcomes after OHCA between relevant units of the healthcare system such as receiving hospitals in Japan. Therefore, we aimed to quantify the variation in patient outcomes after OHCA between receiving hospitals in Japan. ⋯ We found substantial variations in patient outcomes after OHCA within a large group of hospitals in Japan, despite adjustment for patient factors that are known to be associated with different outcomes.
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Emergency drug preparation and administration in children is both complex and time-consuming and places this population at a higher risk than adults for medication errors. Moreover, survival and a favorable neurological outcome from cardiopulmonary resuscitation are inversely correlated to drug preparation time. We developed a mobile device application (the pediatric Accurate Medication IN Emergency Situations (PedAMINES) app) as a step-by-step guide for the preparation to delivery of drugs requiring intravenous injection. In a previous multicenter randomized trial, we reported the ability of this app to significantly reduce in-hospital continuous infusion medication error rates and drug preparation time compared to conventional preparation methods during simulation-based pediatric resuscitations. This trial aims to evaluate the effectiveness of this app during pediatric out-of-hospital cardiopulmonary resuscitation. ⋯ This clinical trial will assess the impact of an evidence-based mobile device app to reduce the rate of medication errors, time to drug preparation and time to drug delivery during prehospital pediatric resuscitation. As research in this area is scarce, the results generated from this study will be of great importance and may be sufficient to change and improve prehospital pediatric emergency care practice.
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Randomized Controlled Trial Multicenter Study
Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest.
Patients who are treated with targeted temperature management after out-of-hospital cardiac arrest with shockable rhythm are at increased risk for ventilator-associated pneumonia. The benefit of preventive short-term antibiotic therapy has not been shown. ⋯ A 2-day course of antibiotic therapy with amoxicillin-clavulanate in patients receiving a 32-to-34°C targeted temperature management strategy after out-of-hospital cardiac arrest with initial shockable rhythm resulted in a lower incidence of early ventilator-associated pneumonia than placebo. No significant between-group differences were observed for other key clinical variables, such as ventilator-free days and mortality at day 28. (Funded by the French Ministry of Health; ANTHARTIC ClinicalTrials.gov number, NCT02186951.).