Resuscitation
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Current resuscitation guidelines advise a single biphasic shock followed by chest compressions; however, it is unclear if this applies to all waveforms and energy levels. We conducted a systematic review of the literature to determine the comparative success rates for single-shock defibrillation across waveforms evaluated in out-of-hospital cardiac arrest patients. ⋯ This systematic review suggests that evaluated biphasic waveforms have similar first-shock success as measured by the three outcomes of interest and all are superior to monophasic shocks.
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Multicenter Study
Association between angiographic culprit lesion and out-of-hospital cardiac arrest in ST-elevation myocardial infarction patients.
Factors related to the occurrence of out-of-hospital cardiac arrest (OHCA) in ST-elevation myocardial infarction (STEMI) are still poorly understood. The current study sought to compare STEMI patients presenting with and without OHCA to identify angiographic factors related to OHCA. ⋯ In the present STEMI population, coronary culprit lesion was associated with the occurrence of OHCA. Moreover, culprit lesion influenced the risk of cardiogenic shock and success of reperfusion, both of which were related to prognosis of OHCA patients.
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The American Heart Association, the European Resuscitation and the International Liaison Committee issued new neonatal resuscitation guidelines (2010) where therapeutic hypothermia is introduced after hypoxic-ischaemic encephalopathy (HIE) in term infants to prevent brain injury. Our study aimed to investigate whether hypothermia can reduce the release of a cardiac cellular marker, cardiac troponin I (cTnI), in HIE infants compared to normothermia care, if cTnI can be used as a prognostic marker for long term neuro-developmental outcome and if cardiac compression at birth affects the level of cTnI. ⋯ Our results suggest that hypothermia is cardio protective after HIE. The level of cTnI at 24h of age is a good prognostic marker for neuro-developmental outcome at 18-22 months in both normothermia and hypothermia infants.
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Recent simplified guidelines recommend Hands-Only CPR for laypersons and efforts to educate the public of these changes have been made. We determined current knowledge of and willingness to perform Hands-Only CPR. ⋯ Less than one fifth of surveyed laypersons knew of Hands-Only CPR yet three quarters would be willing to perform Hands-Only CPR even on a stranger. Efforts to increase layperson education are required to enhance CPR performance.