Resuscitation
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To develop and evaluate a method to detect circulation in the presence of organized rhythms (ORs) during resuscitation using signals acquired by defibrillation pads. ⋯ The method showed good performance, and can be reliably used to distinguish perfusing from non-perfusing ORs.
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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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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.
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Each year, 200,000 patients undergo an in-hospital cardiac arrest (IHCA), with approximately 15-20% surviving to discharge. Little is known, however, about the long-term prognosis of these patients after discharge. Previous efforts to describe out-of-hospital survival of IHCA patients have been limited by small sample sizes and narrow patient populations ⋯ Survival rates were varied widely with different discharge destinations, and those discharged to home, skilled nursing facilities or to rehabilitation services had survival rates no different than controls. Thus, increased mortality was primarily driven by patients discharged to long-term care or hospice.