Resuscitation
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Comparative Study Clinical Trial
Complications Associated with the Prehospital Use of Laryngeal Tubes A Systematic Analysis of Risk Factors and Strategies for Prevention.
With the increasing spread of laryngeal tubes (LT) in emergency medicine, complications and side-effects are observed. We sought to identify complications associated with the use of LTs in emergency medicine, and to develop strategies to prevent these incidents. ⋯ The prehospital use of LTs may result in severe and even life-threatening complications. Likely, such complications could have been prevented by using gastric drainage and cuff pressure adjustment. Both, prehospital health care providers and emergency department staff should develop a greater awareness of such complications to best avoid them in the future.
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Randomized Controlled Trial Comparative Study Observational Study
The Dispatcher Assisted Resuscitation Trial: Indirect Benefits of Emergency Research.
Conduct of emergency research under waiver of consent produces special challenges. Moreover, the act of performing research may have unintended effects, potentially beneficial or detrimental. The Dispatcher-Assisted Randomized Trial (DART) was designed to compare 2 types of dispatcher cardiopulmonary (CPR) instruction, but not intended to affect the proportion of arrest victims that received bystander CPR. We sought to determine whether odds of receiving bystander CPR were higher during DART than during the periods before and after. ⋯ Odds of bystander CPR were higher during the trial, an increase related to higher likelihood of DA-CPR. The finding suggests a possible indirect community-wide benefit due to the interventional trial.
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Multicenter Study
Epidemiology And Outcomes Of In-Hospital Cardiac Arrest In Critically Ill Children Across Hospitals Of Varied Center Volume: A Multi-Center Analysis.
To describe epidemiology and outcomes associated with cardiac arrest among critically ill children across hospitals of varying center volumes. ⋯ Both incidence of cardiac arrest, and mortality in those with cardiac arrest vary substantially across hospitals. However, center volume is not associated with either of these outcomes, after adjusting for patient and center characteristics.
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Multicenter Study Observational Study
Admission interleukin-6 is associated with post resuscitation organ dysfunction and predicts long-term neurological outcome after out-of-hospital ventricular fibrillation.
To study plasma concentrations of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and S-100B during intensive care after out-of-hospital cardiac arrest from ventricular fibrillation (OHCA-VF), and their associations with the duration of ischemia, organ dysfunction and long-term neurological outcome. ⋯ Admission high IL-6, but not hs-CRP or S-100B, is associated with extra-cerebral organ dysfunction and along with age and time to ROSC are independent predictors for 12-month poor neurologic outcome (CPC 3-5).
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Comparative Study
Extracorporeal life support as rescue strategy for out-of-hospital and Emergency Department cardiac arrest.
Extracorporeal life support (ECLS) has been utilized as a rescue strategy for patients with cardiac arrest unresponsive to conventional cardiopulmonary resuscitation. ⋯ ECLS shows promise as a rescue strategy for refractory out-of-hospital or ED cardiac arrest but is not without challenges. Further investigations are necessary to refine the technique, patient selection, and ancillary therapeutics.