Articles: cardiac-arrest.
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Critical care medicine · Jan 2025
Nelonemdaz Treatment for Patients With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial.
Nelonemdaz is a N-methyl d-aspartate receptor subtype 2B-selective N-methyl-D-aspartate receptor antagonist and a potent free-radical scavenger that might ameliorate hypoxic-ischemic brain injury after out-of-hospital cardiac arrest (OHCA). We investigated the efficacy of nelonemdaz for patients with OHCA. ⋯ Nelonemdaz treatment of patients after OHCA did not reduce serum NSE levels compared with controls. Patients treated with high-dose nelonemdaz showed higher brain MRI fractional anisotropy suggesting less cerebral white matter damage.
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Factors contributing to worse outcomes for out-of-hospital cardiac arrests (OHCA) from minoritized communities are poorly understood. We sought to evaluate the impact of receiving hospital performance on OHCA outcome disparities. ⋯ OHCAs from Black and Hispanic/Latino communities received care at high-performing hospitals less often, and adjusting for receiving hospital significantly diminished OHCA outcome disparities.
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Survival from out-of-hospital cardiac arrests (OHCA) remains lower in rural areas. Longer Emergency Medical Services (EMS) response times suggests that rural OHCA survival may need to rely more on early bystander intervention. This study compares the rates of bystander Cardiopulmonary Resuscitation (CPR) between rural and urban areas and examines societal factors associated with bystander CPR. ⋯ We observed lower rates of bystander CPR in communities with lower education, higher rates of non-Caucasian populations, and older populations. Our findings emphasize the need for public interventions in bystander CPR training to meet the needs of diverse community characteristics, and particularly in areas where EMS response times may be longer.
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Out-of-hospital cardiac arrest (OHCA) victims receiving defibrillation from an automated external defibrillator (AED) placed early in the chain of survival are more likely to survive. We sought to explore the accuracy of AED pad placement for lay rescuers (LR) and first responders (FR). ⋯ There is an opportunity for improvement for both LRs and FRs to apply AEDs per manufacturer's recommendations. Further research is needed to improve instructions and follow-up training to ensure accurate AED pad placement.