Resuscitation
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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.
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Over five percent of infants born worldwide will need help breathing after birth. Delayed cord clamping (DCC) has become the standard of care for vigorous infants. DCC in non-vigorous infants is uncommon because of logistical difficulties in providing effective resuscitation during DCC. In Baby-Directed Umbilical Cord Clamping (Baby-DUCC), the umbilical cord remains patent until the infant's lungs are exchanging gases. We conducted a feasibility study of the Baby-DUCC technique. ⋯ It is feasible to provide resuscitation to term and near-term infants during DCC, after both vaginal and cesarean births, clamping the umbilical cord only when the infant is physiologically ready.
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Randomized Controlled Trial Multicenter Study
Acute kidney injury after out of hospital pediatric cardiac arrest.
Many children with return of spontaneous circulation (ROSC) following cardiac arrest (CA) experience acute kidney injury (AKI). The impact of therapeutic hypothermia on the epidemiology of post-CA AKI in children has not been fully investigated. ⋯ Severe AKI occurs frequently in children with ROSC after OHCA, especially in younger children and those with higher initial lactates and hemodynamic support. Severe AKI was associated with worse survival and functional outcome. Therapeutic hypothermia did not reduce the incidence of severe AKI.
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Randomized Controlled Trial Multicenter Study
Highly malignant routine EEG predicts poor prognosis after cardiac arrest in the Target Temperature Management trial.
Routine EEG is widely used and accessible for post arrest neuroprognostication. Recent studies, using standardised EEG terminology, have proposed highly malignant EEG patterns with promising predictive ability. ⋯ Highly malignant routine EEG after targeted temperature management is a strong predictor of poor outcome. A benign EEG is an important indicator of a good outcome for patients remaining in coma.