Resuscitation
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Randomized Controlled Trial Multicenter Study
Influence of mannan-binding lectin and MAp44 on outcome in comatose survivors of out-of-hospital cardiac arrest.
The lectin complement pathway, initiated by mannan-binding-lectin (MBL) plays a role in tissue destruction following ischemia/reperfusion, and MBL deficiency has been associated with favorable outcome in stroke patients. MAp44 is produced in the heart and may theoretically function as an endogenous inhibitor of MBL-mediated activities. The aim of this study was to investigate the possible association between MBL deficiency, MAp44 levels and outcome in comatose survivors of out-of-hospital cardiac arrest (OHCA). ⋯ In comatose survivors after cardiac arrest, neither MBL deficiency nor levels of MBL and MAp44 were associated with mortality or neurological outcome.
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Randomized Controlled Trial Comparative Study
Frequency of Early Warning Score assessment and clinical deterioration in hospitalized patients: A randomized trial.
To explore whether early warning score (EWS) measurements at 8h intervals is associated with better outcomes than 12h intervals. We hypothesized that the proportion of patients that deteriorated to a higher EWS at 24h after hospital admission would be lower with 8h interval than with 12h interval. ⋯ We found no significant reduction in the proportion of clinical deterioration with monitoring frequencies of 3 vs. 2 times daily among patients acutely admitted to a surgical or medical ward and an initial EWS of 0-1.
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Brain injury is the leading cause of morbidity and death following pediatric cardiac arrest. Serum biomarkers of brain injury may assist in outcome prognostication. The objectives of this study were to evaluate the properties of serum ubiquitin carboxyl-terminal esterase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) to classify outcome in pediatric cardiac arrest. ⋯ Preliminary data suggest that serum UCH-L1 and GFAP may be of use to prognosticate outcome after pediatric cardiac arrest at clinically-relevant time points and should be validated prospectively.
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In mechanically ventilated (MV) cardiac arrest (CA) survivors admitted to the intensive care unit (ICU) avoidance of hypoxia is considered crucial. However, avoidance of hyperoxia may also be important. A conservative approach to oxygen therapy may reduce exposure to both. ⋯ Our findings provide preliminary support for the feasibility and physiological safety of conservative oxygen therapy in patients admitted to ICU for MV support after cardiac arrest (Trial registration, NCT01684124).
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This porcine study was designed to explore the effects of repetitive intravenous adrenaline doses on physiologic parameters during CPR. ⋯ Repetitive intravenous adrenaline doses increased ABP's and to some extent also CePP, but significantly decreased organ and brain perfusion. The institutional protocol number: Malmö/Lund Committee for Animal Experiment Ethics, approval reference number: M 192-10.