Resuscitation
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Review Meta Analysis
Predicting outcome of drowning at the scene: A systematic review and meta-analyses.
To identify factors available to rescuers at the scene of a drowning that predict favourable outcomes. ⋯ Increasing submersion duration was associated with worse outcomes. Submersion durations <5min were associated with favourable outcomes, while those >25min were invariably fatal. This information may be useful to rescuers and EMS systems deciding when to perform a rescue versus a body recovery.
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Limited data are available concerning the impact of CPR interventions on cerebral oxygenation during hypothermic cardiac arrest. We therefore studied cerebral perfusion pressure (CPP), brain tissue oxygen tension (PbtO2), cerebral venous oxygen saturation (ScvO2) and regional cerebral oxygen saturation (rSO2) in an animal model of hypothermic CPR. We also assessed the correlation between rSO2 and CPP, PbtO2 and ScvO2 to clarify whether near-infrared spectroscopy (NIRS) may be used to non-invasively monitor changes in cerebral oxygenation during hypothermic CPR. ⋯ In this animal model of hypothermic cardiac arrest adrenaline was associated with an increase in global cerebral oxygen extraction despite an increase in CPP. Discrepancies in the time course of PbtO2 and ScvO2 suggest differences in regional oxygen metabolism after adrenalin. rSO2 values correlated closely with CPP and ScvO2 only during periods of external chest compression without adrenaline administration.
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Observational Study
Better prognostic value with combined optic nerve sheath diameter and grey-to-white matter ratio on initial brain computed tomography in post-cardiac arrest patients.
We aimed to evaluate the prognostic value of optic nerve sheath diameter (ONSD) and grey-to-white matter (GWR) either alone or in combination in patients treated with targeted temperature management (TTM) after cardiac arrest (CA). ⋯ The combination of ONSD and GWR yielded improved prognostic value for predicting poor neurologic outcomes in post cardiac arrest patients treated with TTM.
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Multicenter Study Observational Study
NT-proBNP in patients with out-of-hospital cardiac arrest: Results from the FINNRESUSCI Study.
To assess whether the established cardiovascular biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP) provides prognostic information in patients with out-of-hospital cardiac arrest due to ventricular tachycardia or fibrillation (OHCA-VT/VF). ⋯ NT-proBNP levels at 24h improved risk assessment for poor outcome after one year on top of established risk indices, while hs-TnT measurements did not further add to risk prediction.
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Randomized Controlled Trial
Viewing a brief chest-compression-only CPR video improves bystander CPR performance and responsiveness in high school students: A cluster randomized trial.
CPR training in schools is a public health initiative to improve out of hospital cardiac arrest (OHCA) survival. It is unclear whether brief video training in students improves CPR quality and responsiveness and skills retention. ⋯ Brief CPR video training resulted in improved CPR quality and responsiveness in high school students. Compression depth only improved with traditional class training. This suggests brief educational interventions are beneficial to improve CPR responsiveness but psychomotor training is important for CPR quality.