Resuscitation
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Multicenter Study
Long-term prognosis after out-of-hospital cardiac arrest with/without ST elevation myocardial infarction.
To describe the 3-year survival of patients after out-of-hospital cardiac arrest (OHCA) taking into account the presence of ST-segment elevation myocardial infarction (STEMI) and evaluating prognostic factors associated with pre-hospital and hospital care. ⋯ Among 560 individuals with "primary cardiac" etiology OHCA and initiation of professional CPR, 8% survived 1 year and 7% survived 3 years. A higher survival rate among patients with STEMI was documented.
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Emergency medical services (EMS) in Hong Kong, now a Special Administrative Region of the People's Republic of China, have a distinguished history spanning more than 50 years. This paper outlines the history and the development of the Hong Kong EMS, with a particular focus on the ambulance service, the design of the system and the training of its staff.
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To assess the prognostic value of repetitive serum samples of neuron specific enolase (NSE) and S-100B in cardiac arrest patients treated with hypothermia. ⋯ NSE was a better marker than S-100B for predicting outcome after cardiac arrest and induced hypothermia. NSE above 28microg/l at 48h and a rise in NSE of more than 2microg/l between 24 and 48h were markers for a poor outcome.
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Serum glial fibrillary acidic protein (GFAP) has recently been identified as a specific predictor of brain damage and neurological outcome in patients with head trauma. In this study, serum GFAP was assessed as a predictor of neurological outcome in post-cardiac-arrest (PCA) patients. ⋯ Although this study is preliminary, serum GFAP after ROSC reflected a poor neurological outcome in PCA patients.
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Randomized Controlled Trial
Reduced effectiveness of vasopressin in repeated doses for patients undergoing prolonged cardiopulmonary resuscitation.
The efficacy of repeated administration of vasopressin alone during prolonged cardiopulmonary resuscitation (CPR) remains unconfirmed. This study was conducted to estimate the effectiveness of the repeated administration of vasopressin vs. epinephrine for cardiopulmonary arrest (CPA) patients receiving prolonged CPR. ⋯ This is the first report of a possible vasopressin-alone resuscitation without additional epinephrine. However, repeated injections of either vasopressin or epinephrine during prolonged advanced cardiac life support resulted in comparable survival.