Resuscitation
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Controlled Clinical Trial
Diffusion and perfusion MRI of the brain in comatose patients treated with mild hypothermia after cardiac arrest: a prospective observational study.
Outcome for resuscitated cardiac arrest (CA) patients is poor. The 1-year survival rate with favourable neurological outcome (CPC 1-2) after out-of-hospital CA is reported to be 4%. Among resuscitated patients treated within an ICU, approximately 50% regain consciousness, whereas the other 50% remain comatose before they die. Induced hypothermia significantly improves the neurological outcome and survival in patients with primary CA who remain comatose after return of spontaneous circulation. ⋯ Diffusion and perfusion MRI are potentially helpful tools for the evaluation of ischaemic brain damage in resuscitated comatose patients treated with hypothermia after CA.
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Determine the use of bispectral index (BIS) as prognostic tool in therapeutic hypothermia (TH) treated comatose survivors after cardiac arrest (CA), regardless of initial rhythm, location or cause. ⋯ BIS values of 0 help predict bad neurological outcome after CA and induced hypothermia.
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To evaluate the use of a structured training programme in emergency care in Pakistan through the completion of logbooks documenting actual resuscitation attempts. ⋯ Resuscitation logbooks can be used to assess which skills are used in emergency care. This analysis provides some evidence that the skills taught during the ESS-EMCH programme are used by the trained health workers. Individually held and completed logbooks should continue to act as a feedback and audit mechanism to measure outcomes, in conjunction with other methods of evaluating the impact of the training component of this programme.
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Controlled Clinical Trial
Influence of chest compression rate guidance on the quality of cardiopulmonary resuscitation performed on manikins.
The adequate chest compression rate during CPR is associated with improved haemodynamics and primary survival. To explore whether the use of a metronome would affect also chest compression depth beside the rate, we evaluated CPR quality using a metronome in a simulated CPR scenario. ⋯ Metronome guidance corrected chest compression rates for each compression cycle to within guideline recommendations, but did not affect chest compression quality or rescuer fatigue.
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Complete neurological recovery is of great importance to survivors of cardiac arrest. Few studies have explored predictors of good cerebral performance outcomes among these. ⋯ Survivors of out-of-hospital cardiac arrest with recovery to good cerebral performance were more likely to have cardiac cause of arrest and show positive pupillary reflex and spontaneous respiration at ED arrival.