Articles: cardiac-arrest.
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Intensive care medicine · Nov 2016
Review Meta AnalysisThe rate of brain death and organ donation in patients resuscitated from cardiac arrest: a systematic review and meta-analysis.
The occurrence of brain death in patients with hypoxic-ischaemic brain injury after resuscitation from cardiac arrest creates opportunities for organ donation. However, its prevalence is currently unknown. ⋯ In patients with hypoxic-ischaemic brain injury following CPR, more than 10 % of deaths were due to brain death. More than 40 % of brain-dead patients could donate organs. Patients who are unconscious after resuscitation from cardiac arrest, especially when resuscitated using e-CPR, should be carefully screened for signs of brain death.
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Review Meta Analysis
Amiodarone and cardiac arrest: Systematic review and meta-analysis.
The 2015 Guidelines for Resuscitation recommend amiodarone as the antiarrhythmic drug of choice in the treatment of resistant ventricular fibrillation or pulseless ventricular tachycardia. We reviewed the effects of amiodarone on survival and neurological outcome after cardiac arrest. ⋯ Amiodarone significantly improves survival to hospital admission. However there is no benefit of amiodarone in survival to discharge or neurological outcomes compared to placebo or other antiarrhythmics.
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Review Meta Analysis
Mechanical chest compression devices at in-hospital cardiac arrest: A systematic review and meta-analysis.
To summarise the evidence in relation to the routine use of mechanical chest compression devices during resuscitation from in-hospital cardiac arrest. ⋯ Mechanical chest compression devices may improve patient outcome, when used at in-hospital cardiac arrest. However, the quality of current evidence is very low. There is a need for randomised trials to evaluate the effect of mechanical chest compression devices on survival for in-hospital cardiac arrest.
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Meta Analysis
Use of targeted temperature management after out-of-hospital cardiac arrest: A meta-analysis of randomized controlled trials.
Individual randomized trials have yielded variable results regarding the benefits of targeted temperature management in patients encountering out-of-hospital cardiac arrest. This study aimed to systemically determine if targeted temperature management initiated after an out-of-hospital cardiac arrest was associated with improved outcomes. ⋯ Targeted temperature management initiated after successful resuscitation in patients who encountered an out-of-hospital cardiac arrest was associated with a nonsignificant reduction in mortality and poor neurological outcome. Lack of benefit was strongly influenced by inclusion of one study that used mild hypothermia in the control arm. These results indicate that only mild hypothermia may be needed to improve outcomes among patients presenting with an out-of-hospital cardiac arrest.
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Review Meta Analysis
Systematic review and meta-analysis of hemodynamic-directed feedback during cardiopulmonary resuscitation in cardiac arrest.
Physiologic monitoring of resuscitative efforts during cardiac arrest is gaining in importance, as it provides a real-time window into the cellular physiology of patients. The aim of this review is to assess the quality of evidence surrounding the use of physiologic monitoring to guide cardiopulmonary resuscitation (CPR), and to examine whether the evidence demonstrates an improvement in patient outcome when comparing hemodynamic-directed CPR versus standard CPR. ⋯ These results suggest a trend in survival from hemodynamic-directed CPR over standard CPR, however the small sample size and lack of human data make these results of limited value. Future human studies examining hemodynamic-directed CPR versus current CPR standards are needed to enhance our understanding of how to effectively use physiologic measures to improve resuscitation efforts and ultimately incorporate concrete targets into international resuscitation guidelines.