Resuscitation
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Observational Study
Detection and quantification of gasping during resuscitation for out-of-hospital cardiac arrest.
To detect and quantify gasping during cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA) patients and to investigate whether gasping is associated with increased return of spontaneous circulation (ROSC). ⋯ The occurrence of gasping during CPR was high. Significant gasping volumes were measured. The presence or absence of gasping was not associated with ROSC, but higher gasping rate and deeper negative pressures were.
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Observational Study
Epileptiform discharge detection with the 4-channel frontal electroencephalography during post-resuscitation care.
We performed this study to investigate whether the SEDline system, a 4-channel-processed electroencephalography (EEG) monitoring device in the frontal area, can detect epileptiform discharges accurately during post-resuscitation care in comatose cardiac arrest survivors. ⋯ The SEDline system detected epileptiform discharges accurately in comatose cardiac arrest survivors during post-resuscitation care.
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Traditional predictors of neurological prognosis after cardiac arrest are unreliable after targeted temperature management. Absence of pupillary reflexes remains a reliable predictor of poor outcome. Diffusion-weighted imaging has emerged as a potential predictor of recovery, and here we compare imaging characteristics to pupillary exam. ⋯ Post-anoxic diffusion changes using quantitative brain MRI may aid in predicting persistent coma and poor functional outcomes at hospital discharge.
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Observational Study
Double sequential defibrillation therapy for out-of-hospital cardiac arrests: the London experience.
Despite advances in treatment for out-of-hospital cardiac arrest (OHCA), a subgroup of patients remain in refractory ventricular fibrillation (RVF) during resuscitation. Recent evidence suggests that double sequential defibrillation (DSD), where two shocks are delivered to the patient in quick succession, may provide an effective therapy for RVF. This study describes the characteristics and survival outcomes of OHCA patients treated by ambulance clinicians using a local DSD protocol in an attempt to resolve RVF. ⋯ Our observational study did not find any clear benefit of DSD use by EMS in the treatment of RVF. However, we find that 3 patients, who were treated with DSD following unsuccessful single shocks, had their VF terminated. Prospective randomised clinical trials are urgently needed to investigate the potential value of DSD in the pre-hospital setting.
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Observational Study
"Presumed cardiac" arrest in children and young adults: A misnomer?
To use a novel methodology to assess the incidence and specific causes of Out-of-Hospital Cardiac Arrest (OHCA) within a young urban cohort. ⋯ In young adults with OHCA, confirmed cardiac causes were responsible in a minority of cases, and they differed in presentation from those with confirmed non- cardiac causes. Establishing rigorous case ascertainment strategies with linkage to multiple data sources will facilitate a more reliable evaluation of the causes of these events.