Resuscitation
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Randomized Controlled Trial Multicenter Study
Neuron-specific enolase and S-100b in prolonged targeted temperature management after cardiac arrest: A randomised study.
We aimed to investigate the impact of prolonged targeted temperature management (TTM) in cardiac arrest patients on release of serum levels of NSE and S-100b and their prognostic performances. ⋯ No clinically relevant differences were found in the levels of NSE or S-100b between standard and prolonged TTM. Prognostic reliability of NSE and S-100b was unaltered by prolonged TTM.
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Multicenter Study Observational Study
Telephone Cardiopulmonary Resuscitation is Independently Associated with Improved Survival and Improved Functional Outcome after Out-of-Hospital Cardiac Arrest.
This study aims to quantify the relative impact of Dispatcher-Initiated Telephone cardiopulmonary resuscitation (TCPR) on survival and survival with favorable functional outcome after out-of-hospital cardiac arrest (OHCA) in a population of patients served by multiple emergency dispatch centers and more than 130 emergency medical services (EMS) agencies. ⋯ TCPR is independently associated with improved survival and improved functional outcome after OHCA.
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Multicenter Study
An assessment of ventilation and perfusion markers in out-of-hospital cardiac arrest patients receiving mechanical CPR with endotracheal or supraglottic airways.
Mechanical chest compression (MCPR) devices are considered equivalent to manual compressions in patient outcomes in out-of-hospital cardiac arrest (OHCA). However, recent data suggest possible harm in patients with a supraglottic airway device (SGA) during MCPR. The aim of this study was to evaluate differences in direct and indirect markers of ventilation and perfusion in patients with cardiac arrest receiving MCPR and who had their airway managed with an endotracheal tube (ETT) or SGA. ⋯ In this retrospective study, we found no evidence of differences in markers of ventilation, perfusion or prehospital ROSC and survival in patients with OHCA who had their airway managed with either an ETT or SGA while receiving MCPR.
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Guidelines recommend detecting return of spontaneous circulation (ROSC) by a rising concentration of carbon dioxide in the exhalation air. As CO2 is influenced by numerous factors, no absolute cut-off values of CO2 to detect ROSC are agreed on so far. As trends in CO2 might be less affected by influencing factors, we investigated an approach which is based on detecting CO2-trends in real-time. ⋯ Patients with ROSC differed from patients without ROSC as to the percentage of detected CO2 trends, indicating the potential of our real-time trend-detection approach. Since the study was designed as a proof of principle and its calculated specificity and sensitivity are low, more research is required to implement CO2-trend-detection into clinical use.
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Early detection of deterioration could facilitate more timely interventions which are instrumental in reducing transfer to higher levels of care such as Intensive Care Unit (ICU) and mortality [1,2]. ⋯ EDI detects more deteriorations for the same specificity as the other two scores. Our results show that EDI performs better at predicting deterioration than commonly used NEWS and MEWS.