Resuscitation
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Observational Study
Assessment of the 11-year nationwide trend of out-of-hospital cardiac arrest cases among elderly patients in Japan (2005-2015).
Japan has one of the most rapidly aging societies worldwide. This study aimed to assess the long-term nationwide trend of out-of-hospital cardiac arrest (OHCA) cases among elderly patients in Japan. ⋯ Based on this long-term nationwide observational study in Japan, the number of elderly patients with OHCA increased annually, and a significant improvement in the patients' neurological outcomes was noted regardless of age category, particularly among those with an initially shockable rhythm.
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We aimed to evaluate the associations between the centralization of dispatch centers and dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) for out-of-hospital cardiac arrest (OHCA) patients. ⋯ The centralization of dispatch centers was associated with an improved bystander CPR rate and dispatcher-provided CPR instructions for OHCA patients.
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Observational Study
Continuous surface EMG power reflects the metabolic cost of shivering during targeted temperature management after cardiac arrest.
Shivering may interfere with targeted temperature management (TTM) after cardiac arrest, contributing to secondary brain injury. Early identification of shivering is challenging with existing tools. We hypothesized that shivering detected by continuous surface sEMG monitoring would be validated with calorimetry and detected earlier than by intermittent clinical observation. ⋯ Shivering was detected by sEMG power earlier than by clinical assessment with BSAS, with similar accuracy compared to the indirect calorimetry gold standard. Continuous sEMG monitoring appears useful for clinical assessment and research for shivering during TTM.
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Observational Study
Relationship between time related serum albumin concentration, optic nerve sheath diameter, cerebrospinal fluid pressure, and neurological prognosis in cardiac arrest survivors.
The optimal time to measure serum albumin concentration (SAC) to predict prognosis in cardiac arrest (CA) survivors has not been elucidated. We aimed to compare the relationships between time-related SAC, optic nerve sheath diameter (ONSD), intracranial pressure (ICP), and neurological prognosis in CA survivors. ⋯ A higher ICP was strongly associated with and seemed predictive of poor outcome. Furthermore, the MSAC24/ONSD combination may be a useful predictor of high ICP and poor neurological outcome. Prospective studies should be conducted to confirm these results.
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We aim to evaluate whether implementation of the "Cardiac Arrest Sonographic Assessment" (CASA) protocol reduces the duration of interruptions in CPR during resuscitation of cardiac arrest (CA) compared to the pre-intervention period. ⋯ In this pre and post-intervention study, the implementation of a structured algorithm for ultrasound use during cardiac arrest significantly reduced the duration of CPR interruptions when ultrasound was performed.