Resuscitation
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Multicenter Study Observational Study
Noninvasive regional cerebral oxygen saturation for neurological prognostication of patients with out-of-hospital cardiac arrest: A prospective multicenter observational study.
To investigate the association between regional brain oxygen saturation (rSO2) at hospital arrival and neurological outcomes at 90 days in patients with out-of-hospital cardiac arrest (OHCA). ⋯ The rSO2 at hospital arrival can predict good neurological outcome at 90 days after OHCA.
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Randomized Controlled Trial Comparative Study
Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial.
To compare integrated automated load distributing band CPR (iA-CPR) with high-quality manual CPR (M-CPR) to determine equivalence, superiority, or inferiority in survival to hospital discharge. ⋯ Compared to high-quality M-CPR, iA-CPR resulted in statistically equivalent survival to hospital discharge.
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Review Case Reports
A Systematic Review and Pooled Analysis of CPR-Associated Cardiovascular and Thoracic Injuries.
The incidence of thoracic injuries resulting from cardiopulmonary resuscitation (CPR) is not well characterized. We describe a case in which a CPR-associated atrial rupture was identified with ultrasound and successfully managed in the intensive care unit with a bedside thoracotomy and atrial repair. We then describe a systematic review with pooled data analysis of CPR-associated cardiovascular, pulmonary, pleural, and thoracic wall injuries. ⋯ The incidence of reported CPR-associated cardiovascular and thoracic wall injuries varies widely. CPR with active compression-decompression devices has a higher reported incidence of cardiopulmonary injuries. Bedside ultrasound may be a useful adjunct to assess and risk-stratify patients to identify serious or life-threatening CPR-associated injuries.
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This study investigated temporal trends in the incidence of out-of-hospital cardiac arrests (OHCA) in metropolitan Perth (Western Australia) between 1997 and 2010. ⋯ Over the study period, a decline in the ASIR for OHCAs of presumed cardiac aetiology in Perth was observed. This is largely attributed to a decreasing incidence in the population aged 65-84 years between 1997 and 2002, and is likely the result of improvements in cardiovascular risk profiles that have previously been reported among Western Australian adults. Future studies of the impact of the ageing population are required.
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Comparative Study Observational Study
Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with out-of-hospital cardiac arrest: A prospective observational study.
A favorable neurological outcome is likely to be achieved in out-of-hospital cardiac arrest (OHCA) patients with ventricular fibrillation or pulseless ventricular tachycardia (VF/VT) on the initial electrocardiogram (ECG). However, in patients without pre-hospital restoration of spontaneous circulation despite the initial VF/VT, the outcome is extremely low by conventional cardiopulmonary resuscitation (CPR). Extracorporeal CPR (ECPR) may enhance cerebral blood flow and recovery of neurological function. We prospectively examined how ECPR for OHCA with VF/VT would affect neurological outcomes. ⋯ In OHCA patients with VF/VT on the initial ECG, a treatment bundle including ECPR, therapeutic hypothermia and IABP was associated with improved neurological outcome at 1 and 6 months after OHCA.