Articles: out-of-hospital-cardiac-arrest.
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Randomized Controlled Trial Multicenter Study
Variations in the application of exception from informed consent in a multicenter clinical trial.
Exception from infor med consent (EFIC) is allowed using federal regulations 21 CFR 50.24 and facilitates research on patients with critical conditions such as cardiac arrest. Little is known regarding the differences in the application of EFIC requirements such as community consultation (CC), public disclosure (PD) and patient notification. We sought to characterize variations in the fulfillment of EFIC requirements in a national multicenter clinical trial in the United States. ⋯ EFIC implementation varies across sites and highlight community and regional variation. Different EFIC approaches may be needed to effectively accomplish the goals of community consultation, public disclosure, and patient notification.
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Multicenter Study Clinical Trial Observational Study
Early Lactate Values After Out-of-Hospital Cardiac Arrest: Associations With One-Year Outcome.
Previous studies have shown associations between high admission serum lactate, lower lactate clearance, and increased short-term mortality after out-hospital cardiac arrest (OHCA). We studied whether lactate levels predict long- term outcome after OHCA. ⋯ In the present study time-weighted mean lactate values for the entire ICU stay, and the last measured lactate value in the ICU, but not admission lactate or lactate clearance were independent predictors of poor 1-year outcome.
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Background Little is known about whether cardiopulmonary resuscitation ( CPR ) training can increase bystander CPR in the community or the appropriate target number of CPR trainings. Herein, we aimed to demonstrate community-wide aggressive dissemination of CPR training and evaluate temporal trends in bystander CPR. Methods and Results We provided CPR training (45-minute chest compression-only CPR plus automated external defibrillator use training or the conventional CPR training), targeting 16% of residents. ⋯ The 1-year increment was associated with high-quality bystander CPR (adjusted odds ratio, 1.461; 95% CI, 1.055-2.024). Bystanders who previously experienced CPR training were 3.432 times (95% CI, 1.170-10.071) more likely to perform high-quality CPR than those who did not. Conclusions We trained 23.0% of the residents in the medium-sized city of Osaka, Japan, and demonstrated that the proportion of high-quality CPR performed on the scene increased gradually, whereas that of bystander CPR delivered overall remained stable.
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Multicenter Study
Sex Differences in Receiving Layperson Cardiopulmonary Resuscitation in Pediatric Out-of-Hospital Cardiac Arrest: A Nationwide Cohort Study in Japan.
Background Layperson cardiopulmonary resuscitation ( CPR ) is a crucial intervention for patients with out-of-hospital cardiac arrest ( OHCA ). Although a sex disparity in receiving layperson CPR (ie, female patients were less likely to receive layperson CPR ) has been reported in adults, there are few data in the pediatric population, and we therefore investigated sex differences in receiving layperson CPR in pediatric patients with OHCA. Methods and Results From the All-Japan Utstein Registry, a prospective, nationwide, population-based OHCA database, we included pediatric patients (≤17 years) with layperson-witnessed OHCA from 2005 through 2015. ⋯ After adjustment for age, time of day of arrest, year, witnesses persons, and dispatcher CPR instruction, the sex difference in receiving layperson CPR was not significant (adjusted odds ratio for female subjects 1.14, 95% CI, 0.996-1.31). Conclusions In a pediatric population, female patients with layperson-witnessed OHCA received layperson CPR more often than male patients. After adjustment for covariates, there was no significant association between patient sex and receiving layperson CPR .
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Multicenter Study Observational Study
Factors associated with outcomes in traumatic cardiac arrest patients without prehospital return of spontaneous circulation.
Prognostic factors for the outcomes in traumatic cardiac arrest (TCA) patients transported to hospitals without prehospital return of spontaneous circulation (ROSC) remain uncertain. The aim of this study is to investigate factors associated with outcomes in TCA patients without prehospital ROSC. ⋯ In TCA patients transported to hospitals without prehospital ROSC, resuscitation attempts could be beneficial. We should aim to resuscitate patients as soon as possible with appropriate treatments for trauma patients, early activation of trauma team, and then, as a result, shorter resuscitation time will be achieved.