Resuscitation
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Multicenter Study Comparative Study
Epidemiology and outcomes of poisoning-induced out-of-hospital cardiac arrest.
We aimed to describe and compare the epidemiologic features and outcomes among patients with poisoning-induced out-of-hospital cardiac arrests (POHCAs) according to causative agent groups. ⋯ Using a nationwide OHCA registry, we found that poisonings were responsible for 4.4% of OHCAs of a non-cardiac aetiology. Ingestion of insecticides including organophosphate and carbamate was associated with more favourable outcomes.
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Comparative Study
Resuscitation feedback and targeted education improves quality of pre-hospital resuscitation in Scotland.
Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality and serious neurological morbidity in Europe. Recent studies have demonstrated the adverse physiological consequences of poor resuscitation technique and have shown that quality of cardiopulmonary resuscitation (CPR) is a critical determinant of outcome from OHCA. Telemetry of the defibrillator transthoracic impedance (TTI) trace can objectively measure quality of pre-hospital resuscitation. This study aims to analyse the impact of targeted resuscitation feedback and training on quality of pre-hospital resuscitation. ⋯ Telemetry and analysis of the TTI trace following OHCA allows objective evaluation of the quality of pre-hospital resuscitation. Targeted resuscitation training and ambulance feedback improves the quality of pre-hospital resuscitation. Further studies are required to establish possible survival benefit from this technique.
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Successful resuscitation after cardiac arrest is typically associated with cerebral and myocardial ischemia/reperfusion (I/R)-injury. Recently, we have demonstrated effects of therapeutic hypothermia (HT) and postconditioning with the volatile anesthetic sevoflurane (SEV) on I/R-mediated mechanisms in the heart and brain [Meybohm et al., PLoS One, 2009; Meybohm et al., Crit Care, 2010]. As the intestine is also highly susceptible to I/R-injury, we investigated the influence of HT and SEV on intestinal I/R-mediated events induced by cardiac arrest and successful resuscitation. ⋯ HT and postconditioning with SEV influence the expression and activity of several small intestinal proteins that are possibly involved in intestinal I/R-mediated events following successful cardiopulmonary resuscitation.