Resuscitation
-
Review Meta Analysis
When should chest compressions be paused to analyze the cardiac rhythm?: A systematic review and meta-analysis.
Most guidelines recommend pausing chest compressions at 2 min intervals to analyze the cardiac rhythm. We conducted a systematic review and meta-analysis to define the optimal interval at which to pause chest compressions in adults for cardiac rhythm analysis in any setting. ⋯ There is a paucity of quality evidence to support pausing chest compressions at any singular interval to assess the cardiac rhythm in adults in cardiac arrest in any setting. Very low-quality evidence suggests improved clinical outcomes in patients receiving 200-compression intervals compared with 1- or 3 min intervals.
-
The discovery that mild, induced hypothermia can improve neurological recovery after global moderate to severe hypoxia-ischemia has been a dramatic validation of the strong foundation of preclinical studies that informed current protocols. The major challenge is to find ways to further improve outcomes. As discussed in this review, the findings from large clinical trials of extended cooling are highly concordant with recent animal studies. These findings support the use of precise, carefully selected animal models to refine our strategies to protect babies with moderate to severe encephalopathy before instigating further large trials.
-
Review Meta Analysis
The association of gasping and outcome, in out of hospital cardiac arrest: A systematic review and meta-analysis.
Gasping is common after cardiac arrest, and its frequency decreases over time. The aim of this study was to conduct a meta-analysis to evaluate the association of gasping and survival to discharge in patients who suffered out-of-hospital cardiac arrest. ⋯ Findings of this meta-analysis demonstrated that gasping is common after cardiac arrest, and is associated with increased survival to discharge. Patients who are cardiac arrest with gasping should be promptly resuscitated.
-
Hypoxic ischaemic brain injury (HIBI) is a major cause of disability after cardiac arrest. HIBI leads to impaired cerebral autoregulation such that adequate cerebral perfusion becomes critically dependent on blood pressure. However, the optimal blood pressure after cardiac arrest remains unclear. Therefore, we conducted a systematic review to investigate the association between blood pressure and neurologic outcome patients after cardiac arrest. ⋯ The included studies suggest improved neurologic outcomes are associated with higher blood pressures in patients after cardiac arrest. This study highlights a need for further research to define the optimal management of blood pressure in this population.