Resuscitation
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Multicenter Study Observational Study
Risk factors and outcomes of in-hospital cardiac arrest following pediatric heart operations of varying complexity.
Multi center data regarding cardiac arrest in children undergoing heart operations of varying complexity are limited. ⋯ This study suggests that the patients undergoing high complexity operations are a higher risk group with increased prevalence of post-operative cardiac arrest. These data further suggest that patients undergoing high complexity operations can be rescued after cardiac arrest with a high survival rate.
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We sought to review cellular changes that occur with reperfusion to try to understand whether ischemia-reperfusion injury (RI) is a potentially modifiable therapeutic target for cardioprotection or neuroprotection in patients undergoing cardiopulmonary resuscitation. ⋯ Ongoing research is necessary to assess whether reduction of RI improves patient outcomes.
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Randomized Controlled Trial Comparative Study
Impaired biological response to aspirin in therapeutic hypothermia comatose patients resuscitated from out-of-hospital cardiac arrest.
Acute coronary syndrome is one of the main causes of out-of-hospital cardiac arrest (OHCA). OHCA patients are particularly exposed to high platelet reactivity (HPR) under aspirin (ASA) treatment. The aim was to evaluate HPR-ASA in therapeutic hypothermia comatose patients resuscitated from OHCA. ⋯ This study suggests that impaired response to both intravenous and oral aspirin is frequent in comatose patients resuscitated from OHCA.
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Practice Guideline
The 2015 Resuscitation Council of Asia (RCA) guidelines on adult basic life support for lay rescuers.
This paper introduces adult basic life support (BLS) guidelines for lay rescuers of the resuscitation council of Asia (RCA) developed for the first time. The RCA BLS guidelines for lay rescuers have been established by expert consensus among BLS Guidelines Taskforce of the RCA on the basis of the 2015 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care Science with Treatment Recommendations. ⋯ Role of emergency medical dispatchers in helping lay rescuers recognize cardiac arrest and perform CPR is also emphasized. The RCA guidelines will contribute to help Asian countries establish and implement their own CPR guidelines in the context of their domestic circumstances.
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Early death following cranial trauma is often considered unsurvivable traumatic brain injury (TBI). However, Impact Brain Apnoea (IBA), the phenomenon of apnoea following TBI, may be a significant and preventable contributor to death attributed to primary injury. This paper reviews the history of IBA, cites case examples and reports a survey of emergency responder experience. ⋯ IBA is a potential cause of early death in some head injured patients. The precise mechanisms in humans are poorly understood but it is likely that early, simple interventions to prevent apnoea could improve clinical outcomes.