Resuscitation
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To investigate the epidemiology and outcomes of cardiac arrests associated with opioid overdoses. Recent data suggest that drug overdoses are responsible for more deaths than motor vehicle crashes or firearms in the United States each year, with opioids being involved in majority of drug overdose deaths. Despite the potential for opioids to cause cardiac arrest, few studies have examined this association. ⋯ Cardiac arrest is more common in patients with opioid overdoses in comparison to non-opioid overdoses. The rate of cardiac arrest is increasing disproportionately in patients with opioid overdoses. Opioid overdoses are independent risk factors for both cardiac arrest and mortality in patients with overdoses.
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Little is known about the burden of recurrent out-of-hospital cardiac arrest (OHCA) episodes in initial survivors of OHCA. We sought to investigate the frequency of recurrent OHCA, describe time-to-event trends, and establish baseline predictors of occurrence. ⋯ Recurrent OHCA episodes occur frequently in OHCA survivors, and could account for as many as one-quarter of all deaths at follow-up. Index characteristics may help to identify at-risk patients.
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Good neurological outcome is a major determinant after cardiac resuscitation. Extracorporeal life support may rapidly stabilize the patient, but cerebral ischemia remains a frequent complication relevant for further therapy. The aim of this study was to prove the value of NSE to indicate cerebral injury in patients with extracorporeal support after CPR. ⋯ NSE monitoring reliably indicates relevant cerebral injury in patients on extracorporeal support after cardiopulmonary resuscitation.
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Firstly, to develop an optimised chest compression post mortem computed tomography angiography protocol in the adult human during closed chest compression to investigate cardiopulmonary resuscitation blood flow, and secondly to provide preliminary observations of post-mortem anatomical cardiac chamber movement using a novel radiolucent static chest compression device. ⋯ The study suggests that with further protocol modification and access to human cadavers as near to death as possible, chest compression post mortem computed angiography (CCPMCTA) could be used as a model for the study of human vascular flow and heart movement during CPR.