Resuscitation
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Review Comparative Study
Are patients brain-dead after successful resuscitation from cardiac arrest suitable as organ donors? A systematic review.
To compare the outcome of organs retrieved from patients brain dead due to cardiac arrest (CA) with that of organs retrieved from patients brain dead due to other causes (non-CA). ⋯ Survival rates of kidneys, livers, hearts and intestines retrieved from CA donors were not significantly different from that of organs transplanted from non-CA donors. Patients brain dead after having been resuscitated from cardiac arrest can be considered as potential donors for organ transplantation.
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Improvement in the quality of cardiopulmonary resuscitation (CPR) may improve the survival rate following cardiac arrest. The aims of our study were to describe how recording of CPR maneuvers performed in our emergency department with real-time video and regular feedback learning may improve CPR. ⋯ We analyzed 45 cases, divided into three groups of 15 consecutive patients. Instantaneous rates of chest compression showed variation with 75% exceeding 110 cpm. There was a significant difference in instantaneous rates among groups (135 [112-150] in group 1, 123 [110-136] in group 2 and 124 [111-137] cpm in group 3, P<0.001). Ratio of hands-off time to total manual compression time (%) significantly decreased over time (Spearman correlation=-0.30, P=0.04). There were significant differences in hands-off time per minute among the groups (11 [3-28], 6 [2-21] and 7 [2-19] s min(-1), P<0.001). There was a significant improvement in time delay to first chest compression (11 [5-50], 20 [8-68] and 0 [0-12] s, P=0.01), but not in time delay to first ventilation (91 [31-190], 65 [17-121] and 24 [9-64] s, P=0.08). Data are median [25-75% interquartile]. Regular feedback learning from real-time video recording may improve the quality of major CPR variables.
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The effect of cardiopulmonary resuscitation guideline changes on out-of-hospital survival rates and defibrillation efficacy was investigated. The guideline changes were those recommended by the International Liaison Committee on Resuscitation in 2005. ⋯ This study suggests that in the Wellington Region of New Zealand, the new guidelines have improved survival to hospital but not to discharge. Whilst the guideline changes have resulted in a trend towards decreased shock success rates, ROSC and survival to hospital admission have both increased.