Resuscitation
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Observational Study
Determinants and significance of cerebral oximetry after cardiac arrest: a prospective cohort study.
To study the determinants and the evolution of cerebral oximetry determined by near-infrared spectroscopy after out-of-hospital cardiac arrest of cardiac origin during therapeutic hypothermia and rewarming, and to compare cerebral oximetry values between patients with good and bad prognosis. ⋯ In this prospective cohort of OHCA patients, main determinants of rSO2 were systemic variables. Monitoring of rSO2 does not allow discriminating patients with good or bad outcome, but could be useful for identifying vulnerable periods for the development of neurologic injury.
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Observational Study
Tracheal intubation during pediatric cardiopulmonary resuscitation: A videography-based assessment in an emergency department resuscitation room.
To describe procedural characteristics of tracheal intubation (TI) during cardiopulmonary resuscitation (CPR) in a pediatric emergency department, and to characterize interruptions in CPR associated with TI performance. ⋯ TI during pediatric CPR results in significant interruptions in chest compressions. Procedural outcomes were not significantly different between attempts with and without compressions paused. In children receiving CPR, TI should be performed without pausing chest compressions.
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In-hospital cardiac arrest is a rare event associated with significant morbidity and mortality. The ability to identify the ICU patients at risk for cardiac arrest could allow the clinical team to prepare staff and equipment in anticipation. ⋯ A novel high-risk clinical indicators checklist is feasible and provides timely and accurate identification of the ICU patients at risk for cardiac arrest or code bell activation.
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The grey-to-white matter ratio (GWR) is a reliable predictor of the neurological outcome of out-of-hospital cardiac arrest (OHCA). However, the reliability in patients receiving extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation (ECPR) remains unknown. We evaluated the utility of the GWR in predicting neurological outcomes in ECPR-treated patients. ⋯ In ECPR, GWR of patients with poor outcome was significantly lower than that of patients with good outcome.
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Observational Study
Interaction Effects between Highly-Educated Neighborhoods and Dispatcher-provided Instructions on Provision of Bystander Cardiopulmonary Resuscitation.
Socioeconomic factors of a community are associated with bystander cardiopulmonary resuscitation (BCPR) rates and outcomes of out-of-hospital cardiac arrest (OHCA). This study aimed to test whether dispatcher-provided CPR instruction modifies the association between education level of a community and provision of BCPR. ⋯ OHCA patients in communities with a higher proportion of highly-educated residents were more likely to receive BCPR, and the disparity was more prominent in the group that received dispatcher-provided CPR instruction.